The case for adjuvant chemoradiation for pancreatic cancer
The case for adjuvant chemoradiation for pancreatic cancer
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DOI：
10.1016/j.bpg.2005.11.001
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发表时间：
2006-04-01
影响因子：
3.2
通讯作者：
Regine, W
中科院分区：
文献类型：
--
作者：
Garofalo, M;Flannery, T;Regine, W
尽管目前有最好的治疗方法，但胰腺癌的治疗结果仍然很差。对于少数患有可切除疾病的患者来说，手术仍然是最重要的单一治疗方式，并且仍然是此类患者治疗意向治疗的基石。辅助治疗在这些患者中的价值一直是争论的主题，并导致了美国和欧洲的几个III期随机临床试验。不一致的试验结果以及试验设计的批评导致了关于辅助放化疗的价值的不同结论。本章将批判性地回顾导致这一争议的随机试验，并建立在可切除胰腺癌患者中使用辅助性放化疗的理论基础。还将讨论现代放射治疗提供技术，并对未来的试验设计提出建议。
Despite the best current therapies, treatment outcomes in pancreatic cancer continue to be poor. Surgery remains the single most important curative modality for the minority of patients who present with resectable disease and continues to be the cornerstone of curative-intent therapy in such patients. The value of adjuvant treatment in these patients has been the subject of much debate and has led to several phase III randomized clinical trials in both the United States and Europe. Inconsistent trial results as well as trial design critiques have led to differing conclusions with regard to the value of adjuvant chemoradiotherapy. This chapter will critically review the randomized trials that have led to this controversy and establish a rationale for the use of adjuvant chemoradiation in patients with resectable pancreatic cancer. Modern radiotherapy delivery techniques will also be discussed and future trial designs suggested.