胰腺癌新辅助与辅助放疗进展

Advances in Neoadjuvant and Adjuvant Radiotherapy for Pancreatic Cancer

新辅助和辅助放疗在胰腺癌中的作用还不明确。对于可切除的胰腺癌首选手术,新辅助放疗只是手术存在困难时的补充;对于交界可切除及局部晚期的胰腺癌,基于化疗基础上联合放疗的新辅助治疗方案,可提高R0切除率并提高局控率;由于现有的临床试验的结果不一致,胰腺癌术后辅助放疗存在争议,但对于非R0切除及pN1的患者,建议在辅助化疗的基础上联合放疗。质子治疗进展迅速,合适的患者可以尝试行质子治疗以降低不良事件率。全文对现有的临床试验分析整理,归纳了胰腺癌新辅助和辅助放疗的进展。

The roles of neoadjuvant and adjuvant radiotherapy for pancreatic cancer are still unclear.Surgery is the first choice for resectable pancreatic cancer,and neoadjuvant therapy is a supplement when facing difficulties.For borderline resectable and locally advanced pancreatic cancer,neoadjuvant therapy which combines chemotherapy can improve the R0 resection rate and local control rate.Due to the inconsistent results of existing clinical trials,the application of adjuvant radiotherapy is controversial for pancreatic cancer.However,it is recommended to combine radiotherapy with adjuvant chemotherapy for patients with non-R0 resection and pN1.Proton therapy has been progressed rapidly,and it can be tried for suitable patients to reduce the rate of adverse events.This study summarized the progress of neoadjuvant and adjuvant radiotherapy for pancreatic cancer based on the existing clinical trials.