辅助与新辅助治疗对于胰腺癌的研究前景

Research Prospect of Adjuvant and Neoadjuvant Therapy for Pancreatic Cancer

摘要: 胰腺癌(pancreatic cancer, PC)是目前世界生存率较低的恶性肿瘤之一，其起病期较为隐匿，早期诊断明确较为困难，确诊后大多数为中、晚期，并且胰腺癌的预后很差。因此，迫切需要在包括以外科手术在内的多学科治疗策略方面共同取得进展，即使在可切除疾病的情况下，也存在隐匿性转移。目前，新辅助治疗被认为是胰腺癌手术的一种有前途的替代方案之一。虽然有许多关于辅助以及新辅助放化疗综合治疗的报道，但到目前为止，还没有确凿的证据证明这种策略相对于标准的前期手术的优势，且只有15%~20%的患者在诊断时有可切除的肿瘤。因此，需要有效的多模式治疗概念，包括辅助以及新辅助化疗结合手术综合性治疗。为了使患者术后的生存率以及预后能够得到改善，新辅助治疗的出现在近些年来已经逐步地开展并进行临床实验，成为一个较为引人关注的热点。但是由于胰腺癌新辅助治疗目前在全世界仍然没有确切的标准治疗方案，所以对于此方面的治疗仍然存在着较大的争议，本文综述了胰腺癌辅助与新辅助综合治疗的目前现状以及未来研究前景。

Abstract: Pancreatic cancer (PC) is one of the malignant tumors with lower survival rate in the world at present, its onset stage is relatively hidden, early diagnosis is more difficult, most of them are middle and late stage after diagnosis, and the prognosis of pancreatic cancer is very poor. Therefore, there is an urgent need to make joint progress in multidisciplinary treatment strategies, including surgery, and occult metastasis exists even in the case of resectable diseases. At present, neoadjuvant therapy is considered to be one of the promising alternatives to pancreatic cancer surgery. Although there are many reports about adjuvant and neoadjuvant radiotherapy and chemotherapy, so far, there is no conclusive evidence to prove the advantage of this strategy over standard pre-surgery, and only 15%~20% of patients have resectable tumors at the time of diag-nosis. Therefore, the concept of effective multimodal therapy is needed, including adjuvant and neoadjuvant chemotherapy combined with surgery. In order to improve the postoperative survival rate and prognosis of patients, neoadjuvant therapy has been gradually carried out and clinical trials have been carried out in recent years, which has become a hot spot of concern. However, because there is still no exact standard treatment for pancreatic cancer in the world, the treatment in this area is still controversial. This paper reviews the current situation and future research prospects of adjuvant and neoadjuvant combined therapy for pancreatic cancer.