Sarma Gautam, Bora Hima, Medhi Partha P
Department of Radiation Oncology, All India Institute of Medical Sciences, Guwahati 781101, Assam, India.
Department of Radiation Oncology, Tezpur Medical College and Hospital, Tezpur 784010, Assam, India.
World J Clin Oncol. 2025 Jul 24;16(7):106107. doi: 10.5306/wjco.v16.i7.106107.
Since its inception, localized pancreatic cancer has been identified as a systemic illness. Hence, to increase its survival rates, surgical resection followed by adjuvant chemotherapy is used as a treatment option. A significant barrier, though, is the high morbidity and drawn-out recovery after extensive surgical resection, which may postpone or prohibit the prompt administration of adjuvant therapy. Thereby, acknowledging the efficacy of neoadjuvant therapy in various digestive tract malignancies like rectal, gastric, and oesophagal cancers in enhancing long-term survival and the likelihood of successful resection, researchers have turned their attention to exploring its potential benefits in the context of both resectable and borderline resectable pancreatic cancer (RPC). According to recent data, neoadjuvant chemoradiation has major advantages for both resectable and borderline RPC. These advantages include increased surgical resection rates, longer survival times, decreased recurrence rates, and better overall disease control with a manageable toxicity profile. Despite its benefits, research is still being done to determine the best way to sequence and combine chemotherapy and radiation. Furthermore, studies have demonstrated the potential for customized therapy regimens based on the patient's general health status and the tumor's biological behavior to maximize the neoadjuvant approach. As progress continues, neoadjuvant chemoradiation is set to become a key component of treatment for both resectable and borderline RPC, providing a more efficient way to manage this deadly condition. While further development is required to fully grasp its potential in enhancing long-term patient outcomes, evidence supports its increasing usage in clinical practice.
自其被发现以来，局部胰腺癌就被认定为一种全身性疾病。因此，为了提高其生存率，治疗方案采用手术切除后进行辅助化疗。然而，一个重大障碍是广泛手术切除后的高发病率和漫长恢复期，这可能会推迟或阻碍辅助治疗的及时进行。鉴于新辅助治疗在直肠癌、胃癌和食管癌等各种消化道恶性肿瘤中，在提高长期生存率和成功切除可能性方面的有效性，研究人员已将注意力转向探索其在可切除和临界可切除胰腺癌（RPC）中的潜在益处。根据最新数据，新辅助放化疗对可切除和临界RPC均具有主要优势。这些优势包括提高手术切除率、延长生存时间、降低复发率以及更好地控制整体疾病，且毒性特征可控。尽管有这些益处，但仍在进行研究以确定化疗和放疗的最佳序贯和联合方式。此外，研究表明，根据患者的总体健康状况和肿瘤的生物学行为制定定制化治疗方案，有可能使新辅助治疗方法发挥最大效果。随着研究的不断进展，新辅助放化疗将成为可切除和临界RPC治疗的关键组成部分，为应对这种致命疾病提供更有效的方法。虽然需要进一步发展以充分掌握其在改善患者长期预后方面的潜力，但证据支持其在临床实践中的使用日益增加。
