中国胰腺癌多学科综合治疗模式专家共识(2020版)

Expert consensus on the MDT model of pancreatic cancer in China(2020 Edition)

胰腺癌的病因尚未完全明确,预防便尤为困难。辅助检测手段的灵敏度和特异度低,早诊是世界性难题,现有的治疗手段疗效不满意,且短期内难以突破,总的5年生存率仅7.2%。面对胰腺癌的现状,要加强基础研究、探究其病因和发病机制,去除病因、切断发生发展路径。研发高灵敏度、高特异度的外周血和尿液等检测技术以及影像诊断技术以提高早期诊断率和疗效,但基础和早期诊断技术的研究时间长、费用高,短期内难以见效。因此,急需解决的问题是通过规范的多学科综合治疗(MDT)、优化组合现有的诊疗方法,制定个性化的治疗方案,达到改善疗效的目的。本共识是在第1版的基础上,基于胰腺癌的诊治现状且短期内难以突破的窘境,参照国际、国内成功的诊治经验,结合中国国情、由国内业界众多知名专家参与,经反复推敲、讨论、几易其稿成文。本共识就MDT的意义和宗旨、主要任务、开展的必要客观条件、工作流程、注意事项、相关临床和基础研究、多中心MDT模式探索、eMDT模式探索等方面进行了详细论述,希望能为推动我国胰腺癌MDT的规范化开展、改善胰腺癌的疗效、总结成功经验、促进国际交流、加强人才培养和梯队建设有所裨益;为国家制定相关政策、推动全国MDT的开展有所帮助。本共识不仅仅适用于胰腺癌,也可供其他肿瘤借鉴。

The current situation of pancreatic cancer is that the etiology is not clear and prevention is difficult.The sensitivity and specificity of the auxiliary detection method are low,and early diagnosis is a worldwide problem.The efficacy of existing treatment method is not satisfied and is difficult to break through in a short time.The 5-year overall survival rate is only 7.2%.In face of the current situation of pancreatic cancer,the key solution is to strengthen basic research,explore its etiology and pathogenesis,prevent carcinogenesis and development.Developments of the efficacy of peripheral blood and urine detection technology,imaging diagnosis technology are the critical manners to improve the early diagnosis rate.However,the research on basic and early diagnosis techniques takes a long time and costs a lot,which makes it difficult to achieve result in a short time.Therefore,the problem to be solved urgently is to develop a personalized treatment plan through standardized multi-disciplinary treatment(MDT),optimized combination of existing diagnosis and treatment methods,which may achieve the purpose of improving efficacy.This expert consensus is developed from the first edition,which is based on the diagnosis and treatment status of pancreatic cancer and the dilemma that is difficult to break through in a short time,with reference to the successful diagnosis and treatment experience at home and abroad,combined with the national condition of our country,repeated deliberation,discussion and revision by many domestic well-known experts.This consensus discusses the meaning and purpose,the main tasks,the necessary objective conditions for carrying out,workflows,precautions,relevant clinical and basic research of MDT,explorations of multi-center MDT mode and internet MDT(eMDT)mode in detail.Through the formulation and publication of this consensus,we hope that it can promote the development of standardized pancreatic cancer MDT and improve the therapeutic efficacy of pancreatic cancer in China,summarize successful experience and promote international exchanges,strengthen personnel training and echelon construction,formulate relevant policy and promote the development of MDT in the whole country.This is an expert consensus on the MDT model developed in China,which is not only applied to pancreatic cancer,but also can be used as a reference for other tumors.