Systemic Chemotherapy in Advanced Pancreatic Cancer.
Systemic Chemotherapy in Advanced Pancreatic Cancer.
复制标题
DOI：
10.5009/gnl15465
复制
发表时间：
2016-05-23
期刊：
影响因子：
3.4
通讯作者：
Park SW
中科院分区：
文献类型：
--
作者：
Lee HS;Park SW
胰腺癌仍然是最致命的癌症之一。这些患者通常有多种症状，综合支持护理对于帮助他们尽可能长时间地保持良好状态至关重要。与最好的支持性治疗相比，基于氟尿嘧啶的化疗已知可将总存活率(OS)提高约3个月。1997年的一项比较吉西他滨和氟尿嘧啶治疗晚期胰腺癌患者的研究显示，接受吉西他滨治疗的患者1个月的OS有所改善。在接下来的10年里，多项随机研究将单药吉西他滨与联合化疗进行了比较，结果显示没有有效地改善存活率。然而，加入埃洛替尼，一种表皮生长因子受体(EGFR)抑制剂，与大约2周的OS显著改善有关。然而，由于其疗效有限和毒性增加，采用该方案并未得到广泛应用。最近，两项临床试验将晚期胰腺癌患者的OS延长了近1年。第一个将FOLFIRINOX与单独使用吉西他滨进行比较，并与显著提高中位生存期有关。第二项研究将吉西他滨和NAB-紫杉醇与单独使用吉西他滨进行比较，并与OS的改善有关。目前，这些方案被认为是对状态良好的患者的标准治疗。
Pancreatic cancer remains one of the most lethal cancers. These patients often have multiple symptoms, and integrated supportive care is critical in helping them remain well for as long as possible. Fluorouracil-based chemotherapy is known to improve overall survival (OS) by approximately 3 months, compared to the best supportive care alone. A 1997 study comparing gemcitabine and fluorouracil treatment of advanced pancreatic cancer patients showed an improvement in OS of 1 month in patients receiving gemcitabine. Over the next 10 years, multiple randomized studies compared single-agent gemcitabine with combination chemotherapy and showed no effective survival improvement. However, the addition of erlotinib, an epidermal growth factor receptor (EGFR) inhibitor, was associated with a significant improvement in OS of approximately 2 weeks. However, adoption of this regimen has not been widespread because of its limited effect and added toxicity. Two clinical trials have recently prolonged OS in advanced pancreatic cancer patients by almost 1 year. The first compared FOLFIRINOX with gemcitabine alone, and was associated with a significant improvement in median survival. The second compared gemcitabine and nab-paclitaxel with gemcitabine alone, and was associated with improvements in OS. At present, these regimens are considered standard treatment for patients with good performance statuses.