局部进展期胰腺癌综合治疗的现状与进展

Current status and progress of comprehensive treatment for locally advanced pancreatic cancer

局部进展期胰腺癌合并有周围大血管浸润．根据血管受侵犯程度可分类为可能切除和不可切除。可能切除胰腺癌多需联合血管切除，新辅助治疗可提高R0切除率；不可切除胰腺癌的治疗目的是控制肿瘤进展、延迟远处转移的发生。近期临床研究结果证实：术前化疗、化放疗可使部分局部进展期胰腺癌降期为可切除。笔者结合近年文献，深入探讨手术、新辅助治疗在局部进展期胰腺癌中的地位和作用。

Locally advanced pancreatic cancer （LAPC） involves with adjacent vascular structures, which is divided into the borderline resectable pancreatic cancer （BRPC） and unresectable pancreatic cancer. BRPC is usually treated with vascu- lar restruction. Neoadjuvant therapy plays an important role in achieving an R0 resection in BRPC. Generally, the goal of treatment for unresectable pancreatic cancer is to control tumor progress and improve patients＇ quality of life. The latest cheering clinical trials have shown that some LAPC may be downstaged to resectable tumors after preoperative chemotherapy and chemoradiotherapy. In this article, the rationale for and results following treatment with neoadjuvant chemotherapy, chemoradiation and possibly subsequent surgical resection of the primary tumor are described in detail and existing data are reviewed.