Wagener D J, Punt C J, Wilke H
Division of Medical Oncology, University Hospital Nijmegen St. Radbound, The Netherlands.
Ann Oncol. 1994;5 Suppl 3:87-90. doi: 10.1093/annonc/5.suppl_3.s87.
Pancreatic cancer is associated with an extremely poor prognosis. Even after resection with curative intent, the 5-year survival rates usually do not exceed 5%, and neither radiotherapy (RT) nor chemotherapy (CT) improve long term survival. Because of the poor outcome of patients with localized disease, studies should be directed to selected patients who benefit from surgery and from combined treatment of surgery with chemo-irradiation. Future developments in the treatment of locoregionally confined pancreatic cancer will have to focus on treatment modalities which improve the local tumor control as well as the control of occult distant disease. Combined CT/RT seems to be the most promising approach for these patients. However, to date there are more questions than clearcut answers about what such a multimodality treatment should look like. This concerns the selection of patients, the dosages, time schedules, and routes of administration of CT and RT. Last but not least, there is a need for more effective CT in pancreatic cancer. New drugs and multiple drug combinations should be studied in patients who are not candidates for multimodality treatment because of distant metastases. Well designed trials that address these issues are urgently needed in the forthcoming years.
胰腺癌的预后极差。即使进行了根治性切除，5年生存率通常也不超过5%，放疗（RT）和化疗（CT）均无法提高长期生存率。鉴于局限性疾病患者的预后不佳，研究应针对那些能从手术以及手术联合放化疗中获益的特定患者。局部晚期胰腺癌治疗的未来发展必须聚焦于能够改善局部肿瘤控制以及隐匿性远处疾病控制的治疗方式。联合CT/RT似乎是这类患者最有前景的治疗方法。然而，迄今为止，对于这样一种多模式治疗应该是什么样的，问题比明确的答案更多。这涉及患者的选择、CT和RT的剂量、时间表以及给药途径。最后但同样重要的是，胰腺癌需要更有效的CT治疗。应在因远处转移而不适合多模式治疗的患者中研究新药和多种药物组合。未来几年迫切需要精心设计的试验来解决这些问题。
