Metzger U F, Kisner D L, Ghosh B C
J Surg Oncol. 1983 Oct;24(2):107-12. doi: 10.1002/jso.2930240208.
Since pancreatic cancer is still increasing and has a poor prognosis, there is great interest in improving treatment results by combined modality approaches. This paper considers the most appropriate studies to analyze the status of treatment and future implications for surgeons. With new radiation sources and more sophisticated treatment plans, intra- and post-operative radiotherapy now has an established role in local tumor control. Combination chemotherapy has yielded response rates of 40-45% and improved chemotherapy will play a role in the treatment and perhaps in the prevention of disseminated disease. Although it seems likely that chemotherapy combined with newer radiotherapeutic technique could improve treatment results in advanced pancreatic cancer, treatment-related and limiting toxicity still must be defined. There are suggestions that more surgeons become involved in the combined modality approach, as both radiotherapy and chemotherapy may be more valuable in primary management. The unsatisfactory results of surgical treatment imply the need for adjuvant treatment, which must be tested in randomized multicenter trials. Future efforts will require an interdisciplinary approach to this disease.
由于胰腺癌的发病率仍在上升且预后较差，因此人们对通过综合治疗方法改善治疗效果有着浓厚的兴趣。本文探讨了最恰当的研究，以分析治疗现状以及对外科医生的未来影响。随着新的放射源和更精密的治疗方案的出现，术中和术后放疗目前在局部肿瘤控制中已确立了作用。联合化疗已产生了40% - 45%的缓解率，改进后的化疗将在治疗中发挥作用，或许还能预防播散性疾病。虽然化疗联合更新的放射治疗技术似乎有可能改善晚期胰腺癌的治疗效果，但仍必须明确治疗相关的限制性毒性。有建议提出，更多外科医生应参与到综合治疗方法中，因为放疗和化疗在初始治疗中可能都更有价值。手术治疗结果不尽人意意味着需要辅助治疗，这必须在随机多中心试验中进行检验。未来对这种疾病的研究需要采用跨学科方法。
