Department of Hepato-Biliary-Pancreatic Surgery, Kyorin University Hospital, Tokyo, Japan.
Biosci Trends. 2024;18(3):224-232. doi: 10.5582/bst.2024.01156.
Pancreatic cancer (PC) has the poorest prognosis among digestive cancers; only 15-20% of cases are resectable at diagnosis. This review explores multidisciplinary treatments for advanced PC, emphasizing resectability classification and treatment strategies. For locally advanced unresectable PC, systemic chemotherapy using modified FOLFIRINOX and gemcitabine with albumin-bound paclitaxel is standard, while the role of chemoradiation is debated. Induction chemotherapy followed by chemoradiation may be a promising therapy. Conversion surgery after initial chemotherapy or chemoradiotherapy offers favorable survival, however criteria for conversion need further refinements. For metastatic PC, clinical trials using immune checkpoint inhibitors and molecular targeted therapies are ongoing. Multidisciplinary approaches and further research are crucial for optimizing treatment and improving outcomes for advanced PC.
胰腺癌（PC）是消化系统癌症中预后最差的一种，只有 15-20%的病例在诊断时可进行手术切除。本综述探讨了晚期 PC 的多学科治疗方法，重点介绍了可切除性分类和治疗策略。对于局部晚期不可切除的 PC，使用改良的 FOLFIRINOX 和吉西他滨联合白蛋白结合型紫杉醇的系统化疗是标准治疗，而放化疗的作用仍存在争议。诱导化疗后行放化疗可能是一种有前途的治疗方法。初始化疗或放化疗后行转化手术可带来较好的生存获益，但转化标准仍需进一步完善。对于转移性 PC，正在进行免疫检查点抑制剂和分子靶向治疗的临床试验。多学科方法和进一步的研究对于优化晚期 PC 的治疗和改善预后至关重要。
