不同类型胰腺癌的治疗策略

Treatment strategies for different types of pancreatic cancer

目的探讨不同类型胰腺癌的治疗策略。方法通过阅读近几年国内外胰腺癌治疗的相关文献,对胰腺癌的分类及其治疗措施的进展进行归纳总结。结果依据术前影像学评估将胰腺癌分为可切除胰腺癌、交界可切除胰腺癌、局部进展期胰腺癌和合并远处转移的胰腺癌。可切除胰腺癌应行根治性切除,术后辅以化疗。交界可切除胰腺癌患者中,静脉受侵若能够切除重建,主张行手术治疗,术后行辅助化疗;对于静脉受侵不可切除重建及动脉受侵的患者,应行新辅助治疗,然后对肿瘤的可切除性进行重新评估,明确是否可行手术治疗。局部进展期或合并转移的胰腺癌患者多已失去手术时机,多主张行新辅助放化疗或二线联合靶向治疗。结论大多数胰腺癌患者就诊时肿瘤已进入进展期,熟悉掌握胰腺癌的类型,采取针对性的治疗措施,可改善患者的生存时间。

Objective To explore the treatment strategies of different types of pancreatic cancer. Methods By reading the relevant literatures on the treatment of pancreatic cancer at home and abroad in recent years, the classification of pancreatic cancer and the progress of treatment measures were summarized. Results According to preoperative imaging evaluation, pancreatic cancer was divided into resectable pancreatic cancer, borderline resectable pancreatic cancer, locally advanced pancreatic cancer, and pancreatic cancer with distant metastasis. Resection of pancreatic cancer should be radical resection, supplemented with chemotherapy after surgery;patients with resected pancreatic cancer in the junction, if the patient with venous invasion could be resected and reconstructed, it was recommended to undergo surgery and postoperative adjuvant chemotherapy. Patients with unresectable reconstruction and arterial invasion should undergo neoadjuvant therapy, and then re-evaluate the resectability of the tumor to determine whether surgery was feasible. Patients with locally advanced or combined metastatic pancreatic cancer had lost the opportunity for surgery, for this kind of patient, advocated neoadjuvant chemoradiotherapy or second-line combined targeted therapy. Conclusions Most patients with pancreatic cancer have progressed to the stage of clinical diagnosis. They are familiar with the treatment of different types of pancreatic cancer and take targeted treatment measures to improve the survival time of patients.