胰腺癌新辅助治疗的现状与展望

Current status and perspectives of neoadjuvant therapy for pancreatic cancer

对于不伴远处转移的胰腺癌,以手术为核心的综合治疗渐成为共识。目前,多项大样本回顾性临床研究已凸显新辅助治疗的价值,各权威指南也越来越重视新辅助治疗在胰腺癌中的地位。多项大型前瞻性多中心临床研究正在进行,且多数研究的初步结果均提示新辅助治疗可提高肿瘤的根治性切除率并改善生存。但新辅助治疗在胰腺癌中,特别是在可切除胰腺癌中的应用价值仍存在争议。此外,有关胰腺癌新辅助治疗的方案选择、治疗周期及术后接续的辅助方案等问题目前也尚无共识。相信随着高等级循证医学证据的不断出现,新辅助治疗将在胰腺癌中得到更广泛的应用。

The multimodality therapy with surgery as the core has gradually become the standard therapy for pancreatic cancer without distant metastasis. At present, many large-sample retrospective clinical studies have shown the value of neoadjuvant therapy in pancreatic cancer, and many international guidelines have recognized neoadjuvant therapy as a fundamental part of pancreatic cancer treatment. There are many ongoing large-scale, prospective, multi-center clinical trials, and the primary results of several studies have shown that neoadjuvant therapy can increase the radical resection rate of tumor and improve overall survival. However, there are still controversies over the value of neoadjuvant therapy in pancreatic cancer, especially resectable pancreatic cancer. In addition, no consensus has been reached on the selection of neoadjuvant regimen, the duration of neoadjuvant therapy, and neoadjuvant regimen after surgery for pancreatic cancer. It is believed that with the appearance of high-level evidence, neoadjuvant therapy will be widely used in pancreatic cancer.