作者投稿
专家审稿
编辑办公
邮件订阅
RSS
-
摘要: 为提高我国胰腺癌的总体治疗水平，中华医学会外科学分会胰腺外科学组、中国研究型医院学会胰腺疾病专业委员会组织相关专家制定了本指南。本指南基于推荐分级的评价、制定与评估(Grading of Recommendations Assessment, Development and Evaluation, GRADE)系统，针对胰腺癌新辅助治疗的应用指征、方案选择、疗效评估及其相关病理学诊断、手术策略等热点问题展开讨论，对现有临床研究的证据等级量化评估并提出推荐意见，以指导并促进胰腺癌新辅助治疗的临床实践。本指南强调多学科综合治疗协作组的重要地位，体现出胰腺癌治疗理念的转变。新辅助治疗能够有效延长部分胰腺癌患者的生存期，但仍需开展高质量临床研究，以进一步提升证据等级，完善临床实践方案，改善患者预后。
-
关键词:
- 胰腺肿瘤 /
- 抗肿瘤联合化疗方案 /
- 新辅助治疗 /
- 多学科综合治疗协作组 /
- 临床研究
Abstract: In order to improve the overall treatment level of pancreatic cancer in China, Study Group of Pancreatic Surgery in China Society of Surgery of Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association have formulated the guideline for neoadjuvant therapy of pancreatic cancer in China (2020 edition). Based on the Grading of Recommendations Assessment, Development and Evaluation system, the guideline has conducted a discussion on the indication, regimen selection, therapeutic effect evaluation, pathological diagnosis and surgery strategy, etc. This guideline has quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in the neoadjuvant therapy of pancreatic cancer. The guideline has highlighted the role of multiple disciplinary team and represented the conversion of treatment concept in pancreatic cancer. Neoadjuvant therapy has prolonged the survival of the part of pancreatic cancer patients. However, more high-quality clinical researches are in urgent need to improve the level of evidence, optimize the clinical practice and improve the survival of patients.利益冲突：无 -
表 1 证据等级标准
证据等级及说明 削弱证据强度的因素 提高证据强度的因素 高：真实效应值非常接近估计值
中：真实效应值接近估计值
低：真实效应值可能与估计值存在差异
极低：真实效应值很可能与估计值存在差异(1)研究自身的缺陷，如低质量的随机对照试验，存在偏倚的可能性较大
(2)结果的不一致性
(3)证据的间接性
(4)结果的不确定性
(5)研究很可能存在报告偏倚(1)样本量非常大
(2)有明显的剂量-反应关系
(3)所有可能的偏倚均倾向于削弱干预组的治疗效果
下载: 导出CSV
表 2 胰腺癌可切除性评估标准
状态 动脉 静脉 可切除 肿瘤未触及CA、SMA或CHA 肿瘤与SMV存在间隙，或与PV的触及范围虽≤180°，但静脉轮廓规则 临界可切除 胰头和/或钩突部：(1)肿瘤触及CHA，但未累及CA或肝动脉起始部，允许安全切除和重建；(2)肿瘤触及SMA≤180°；(3)肿瘤触及变异动脉如副肝右动脉、替代肝右动脉、替代CHA及其他替代或副动脉起始部等胰体和/或尾部：(1)肿瘤触及CA≤180°；(2)肿瘤触及CA＞180°但未侵犯主动脉，且胃十二指肠动脉完整 (1)肿瘤触及SMV或PV的范围＞180°；或与SMV、PV的触及范围虽≤180°，但静脉轮廓不规则或合并静脉内血栓形成；受累部位的近端和远端血管正常，完整切除后可安全重建；(2)肿瘤触及IVC 局部进展 胰头和/或钩突部：肿瘤触及SMA或CA＞180°胰体和/或尾部：(1)肿瘤触及SMA或CA＞180°；(2)肿瘤触及CA和主动脉 胰头和/或钩突部：因为肿瘤侵犯或血管阻塞导致SMV、PV无法重建(也可因为瘤栓或血栓导致) CA：腹腔干；SMA：肠系膜上动脉；CHA：肝总动脉；SMV：肠系膜上静脉；PV：门静脉；IVC：下腔静脉
下载: 导出CSV
表 3 胰腺癌常用新辅助治疗方案
方案 体能状态 具体方案 可调整方案 FOLFIRINOX 较好 奥沙利铂85 mg/m2静脉滴注2 h，第1天；伊立替康180 mg/m2静脉滴注30~90 min，第1天；亚叶酸钙400 mg/m2静脉滴注2 h，第1天；氟尿嘧啶400 mg/m2静脉滴注，第1天，然后2400 mg/m2静脉滴注46 h；每2周重复1次 奥沙利铂68 mg/m2静脉滴注2 h，第1天；伊立替康135 mg/m2静脉滴注30~90 min，第1天；亚叶酸钙400 mg/m2静脉滴注2 h，第1天；氟尿嘧啶2400 mg/m2静脉滴注46 h；每2周重复1次 吉西他滨+白蛋白紫杉醇 较好 (1)白蛋白紫杉醇125 mg/m2静脉滴注，第1、8、15天
(2)吉西他滨1000 mg/m2静脉滴注大于30 min，第1、8、15天
以上方案每4周重复1次(1)白蛋白紫杉醇125 mg/m2静脉滴注，第1、8天
(2)吉西他滨1000 mg/m2静脉滴注大于30 min，第1、8天
以上方案每3周重复1次吉西他滨+替吉奥 较好 (1)吉西他滨1000 mg/m2静脉滴注大于30 min，第1、8天
(2)替吉奥：体表面积＜1.25 m2，每次40 mg；体表面积≥1.25 m2且＜1.5 m2，每次50 mg；体表面积≥1.5 m2，每次60 mg，口服，2次/d，第1~14天
以上方案每3周重复1次(1)吉西他滨1000 mg/m2静脉滴注大于30 min，第1、8天
(2)替吉奥：体表面积＜1.25 m2，每次30 mg；体表面积≥1.25 m2且＜1.5m2，每次40 mg；体表面积≥1.5 m2，每次50 mg，口服，2次/d，第1~14天
以上方案每3周重复1次吉西他滨为基础的放化疗 较差 (1)化疗：吉西他滨1000 mg/m2静脉滴注大于30 min，第1、8、15天；每4周重复1次
(2)放疗：2.4 Gy/F，15次，总量36 Gy(1)化疗：吉西他滨1000 mg/m2静脉滴注大于30 min，第1、8天；每3周重复1次
(2)放疗：2.4 Gy/F，15次，总量36 Gy
下载: 导出CSV
-
[1] Balshem H, Helfand M, Schunemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence[J]. J Clin Epidemiol, 2011, 64: 401-406. doi: 10.1016/j.jclinepi.2010.07.015 [2] Guyatt GH, Oxman AD, Kunz R, et al. What is "quality of evidence" and why is it important to clinicians?[J]. BMJ, 2008, 336: 995-998. doi: 10.1136/bmj.39490.551019.BE [3] Guyatt GH, Oxman AD, Sultan S, et al. GRADE guide-lines: 9. Rating up the quality of evidence[J]. J Clin Epidemiol, 2011, 64: 1311-1316. doi: 10.1016/j.jclinepi.2011.06.004 [4] Andrews J, Guyatt G, Oxman AD, et al. GRADE guide-lines: 14. Going from evidence to recommendations: the significance and presentation of recommendations[J]. J Clin Epidemiol, 2013, 66: 719-725. doi: 10.1016/j.jclinepi.2012.03.013 [5] Andrews JC, Schunemann HJ, Oxman AD, et al. GRADE guidelines: 15. Going from evidence to recommendation-determinants of a recommendation's direction and strength[J]. J Clin Epidemiol, 2013, 66: 726-735. doi: 10.1016/j.jclinepi.2013.02.003 [6] de Geus SW, Eskander MF, Bliss LA, et al. Neoadjuvant therapy versus upfront surgery for resected pancreatic adenocarcinoma: A nationwide propensity score matched analysis[J]. Surgery, 2017, 161: 592-601. doi: 10.1016/j.surg.2016.08.040 [7] Mokdad AA, Minter RM, Zhu H, et al. Neoadjuvant Therapy Followed by Resection Versus Upfront Resection for Resectable Pancreatic Cancer: A Propensity Score Matched Analysis[J]. J Clin Oncol, 2017, 35: 515-522. http://www.ncbi.nlm.nih.gov/pubmed/27621388 [8] Lee YS, Lee JC, Yang SY, et al. Neoadjuvant therapy versus upfront surgery in resectable pancreatic cancer according to intention-to-treat and per-protocol analysis: A systematic review and meta-analysis[J]. Sci Rep, 2019, 9: 15662. doi: 10.1038/s41598-019-52167-9 [9] Motoi F, Unno M. Adjuvant and neoadjuvant treatment for pancreatic adenocarcinoma[J]. Jpn J Clin Oncol, 2020, 50:483-489. doi: 10.1093/jjco/hyaa018 [10] Motoi F, Kosuge T, Ueno H, et al. Randomized phase Ⅱ/Ⅲ trial of neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer (Prep-02/JSAP05)[J]. Jpn J Clin Oncol, 2019, 49: 190-194. doi: 10.1093/jjco/hyy190 [11] Versteijne E, Suker M, Groothuis K, et al. Preoperative Chemoradiotherapy Versus Immediate Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Results of the Dutch Randomized Phase Ⅲ PREOPANC Trial[J]. J Clin Oncol, 2020, 38:1763-1773. doi: 10.1200/JCO.19.02274 [12] Jang JY, Han Y, Lee H, et al. Oncological Benefits of Neoadjuvant Chemoradiation With Gemcitabine Versus Upfront Surgery in Patients With Borderline Resectable Pancreatic Cancer: A Prospective, Randomized, Open-label, Multicenter Phase 2/3 Trial[J]. Ann Surg, 2018, 268: 215-222. doi: 10.1097/SLA.0000000000002705 [13] Barnes CA, Krepline AN, Aldakkak M, et al. Is Adjuvant Therapy Necessary for All Patients with Localized Pancreatic Cancer Who Have Received Neoadjuvant Therapy?[J]. J Gastrointest Surg, 2017, 21: 1793-1803. doi: 10.1007/s11605-017-3544-5 [14] Hackert T, Sachsenmaier M, Hinz U, et al. Locally Advanced Pancreatic Cancer: Neoadjuvant Therapy With Folfirinox Results in Resectability in 60% of the Patients[J]. Ann Surg, 2016, 264: 457-463. doi: 10.1097/SLA.0000000000001850 [15] Gemenetzis G, Groot VP, Blair AB, et al. Survival in Locally Advanced Pancreatic Cancer After Neoadjuvant Therapy and Surgical Resection[J]. Ann Surg, 2019, 270: 340-347. doi: 10.1097/SLA.0000000000002753 [16] Philip PA, Lacy J, Portales F, et al. Nab-paclitaxel plus gemcitabine in patients with locally advanced pancreatic cancer (LAPACT): a multicentre, open-label phase 2 study[J]. Lancet Gastroenterol Hepatol, 2020, 5: 285-294. doi: 10.1016/S2468-1253(19)30327-9 [17] Okasha HH, Naga MI, Esmat S, et al. Endoscopic Ultrasound-Guided Fine Needle Aspiration versus Percutaneous Ultrasound-Guided Fine Needle Aspiration in Diagnosis of Focal Pancreatic Masses[J]. Endosc Ultrasound, 2013, 2: 190-193. doi: 10.4103/2303-9027.121239 [18] Lutz MP, Zalcberg JR, Ducreux M, et al. 3rd St. Gallen EORTC Gastrointestinal Cancer Conference: Consensus recommendations on controversial issues in the primary treatment of pancreatic cancer[J]. Eur J Cancer, 2017, 79: 41-49. doi: 10.1016/j.ejca.2017.03.022 [19] Tsuboi T, Sasaki T, Serikawa M, et al. Preoperative Biliary Drainage in Cases of Borderline Resectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgery[J]. Gastroenterol Res Pract, 2016, 2016: 7968201. http://pubmedcentralcanada.ca/pmcc/articles/PMC4736763/ [20] Kuwatani M, Nakamura T, Hayashi T, et al. Clinical Outcomes of Biliary Drainage during a Neoadjuvant Therapy for Pancreatic Cancer: Metal versus Plastic Stents[J]. Gut Liver, 2020, 14: 269-273. doi: 10.5009/gnl18573 [21] Nakamura K, Sho M, Akahori T, et al. A Comparison Between Plastic and Metallic Biliary Stent Placement in Patients Receiving Preoperative Neoadjuvant Chemoradiotherapy for Resectable Pancreatic Cancer[J]. World J Surg, 2019, 43: 642-648. doi: 10.1007/s00268-018-4820-6 [22] Gardner TB, Spangler CC, Byanova KL, et al. Cost-effectiveness and clinical efficacy of biliary stents in patients undergoing neoadjuvant therapy for pancreatic adenocarcinoma in a randomized controlled trial[J]. Gastrointest Endosc, 2016, 84: 460-466. doi: 10.1016/j.gie.2016.02.047 [23] Seo DW, Sherman S, Dua KS, et al. Covered and uncovered biliary metal stents provide similar relief of biliary obstruction during neoadjuvant therapy in pancreatic cancer: a randomized trial[J]. Gastrointest Endosc, 2019, 90: 602-612.e604. doi: 10.1016/j.gie.2019.06.032 [24] Uemura K, Murakami Y, Satoi S, et al. Impact of Preoperative Biliary Drainage on Long-Term Survival in Resected Pancreatic Ductal Adenocarcinoma: A Multicenter Observational Study[J]. Ann Surg Oncol, 2015, 22: S1238-1246. doi: 10.1245/s10434-015-4618-9 [25] Reni M, Balzano G, Zanon S, et al. Safety and efficacy of preoperative or postoperative chemotherapy for resectable pancreatic adenocarcinoma (PACT-15): a randomised, open-label, phase 2-3 trial[J]. Lancet Gastroenterol Hepatol, 2018, 3: 413-423. doi: 10.1016/S2468-1253(18)30081-5 [26] Groot VP, Gemenetzis G, Blair AB, et al. Defining and Predicting Early Recurrence in 957 Patients With Resected Pancreatic Ductal Adenocarcinoma[J]. Ann Surg, 2019, 269: 1154-1162. doi: 10.1097/SLA.0000000000002734 [27] Marchegiani G, Andrianello S, Malleo G, et al. Does Size Matter in Pancreatic Cancer?: Reappraisal of Tumour Dimension as a Predictor of Outcome Beyond the TNM[J]. Ann Surg, 2017, 266: 142-148. doi: 10.1097/SLA.0000000000001837 [28] Bergquist JR, Puig CA, Shubert CR, et al. Carbohydrate Antigen 19-9 Elevation in Anatomically Resectable, Early Stage Pancreatic Cancer Is Independently Associated with Decreased Overall Survival and an Indication for Neoadjuvant Therapy: A National Cancer Database Study[J]. J Am Coll Surg, 2016, 223: 52-65. doi: 10.1016/j.jamcollsurg.2016.02.009 [29] Liu L, Xu HX, Wang WQ, et al. A preoperative serum signature of CEA+/CA125+/CA19-9 ≥1000 U/mL indicates poor outcome to pancreatectomy for pancreatic cancer[J]. Int J Cancer, 2015, 136: 2216-2227. doi: 10.1002/ijc.29242 [30] Vyas SJ, Puri YS, John BJ, et al. Radiological tumor density and lymph node size correlate with survival in resectable adenocarcinoma of the pancreatic head: A retrospective cohort study[J]. J Cancer Res Ther, 2016, 12: 417-421. doi: 10.4103/0973-1482.171358 [31] Casadei R, Di Marco M, Ricci C, et al. Neoadjuvant Chemoradiotherapy and Surgery Versus Surgery Alone in Resectable Pancreatic Cancer: A Single-Center Prospective, Randomized, Controlled Trial Which Failed to Achieve Accrual Targets[J]. J Gastrointest Surg, 2015, 19: 1802-1812. doi: 10.1007/s11605-015-2890-4 [32] Tajima H, Kitagawa H, Tsukada T, et al. A phase I study of neoadjuvant chemotherapy with gemcitabine plus oral S-1 for resectable pancreatic cancer[J]. Mol Clin Oncol, 2013, 1: 768-772. doi: 10.3892/mco.2013.133 [33] Motoi F, Satoi S, Honda G, et al. A single-arm, phase Ⅱ trial of neoadjuvant gemcitabine and S1 in patients with resectable and borderline resectable pancreatic adenocarcino-ma: PREP-01 study[J]. J Gastroenterol, 2019, 54: 194-203. doi: 10.1007/s00535-018-1506-7 [34] Cerullo M, Gani F, Chen SY, et al. Assessing the Financial Burden Associated With Treatment Options for Resectable Pancreatic Cancer[J]. Ann Surg, 2018, 267: 544-551. doi: 10.1097/SLA.0000000000002069 [35] Ettrich TJ, Berger AW, Perkhofer L, et al. Neoadjuvant plus adjuvant or only adjuvant nab-paclitaxel plus gemcitab-ine for resectable pancreatic cancer - the NEONAX trial (AIO-PAK-0313), a prospective, randomized, controlled, phase Ⅱ study of the AIO pancreatic cancer group[J]. BMC Cancer, 2018, 18: 1298. doi: 10.1186/s12885-018-5183-y [36] Tachezy M, Gebauer F, Petersen C, et al. Sequential neoadjuvant chemoradiotherapy (CRT) followed by curative surgery vs. primary surgery alone for resectable, non-metastasi-zed pancreatic adenocarcinoma: NEOPA- a randomized multicenter phase Ⅲ study (NCT01900327, DRKS00003893, ISRCTN82191749)[J]. BMC Cancer, 2014, 14: 411. doi: 10.1186/1471-2407-14-411 [37] Okano K, Suto H, Oshima M, et al. A Prospective Phase II Trial of Neoadjuvant S-1 with Concurrent Hypofractionated Radiotherapy in Patients with Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma[J]. Ann Surg Oncol, 2017, 24: 2777-2784. doi: 10.1245/s10434-017-5921-4 [38] Capello M, Lee M, Wang H, et al. Carboxylesterase 2 as a Determinant of Response to Irinotecan and Neoadjuvant FOLFIRINOX Therapy in Pancreatic Ductal Adenocarcinoma[J]. J Natl Cancer Inst, 2015, 107: djv132. doi: 10.1093/jnci/djv132. [39] Tsai S, Christians KK, George B, et al. A Phase Ⅱ Clinical Trial of Molecular Profiled Neoadjuvant Therapy for Localized Pancreatic Ductal Adenocarcinoma[J]. Ann Surg, 2018, 268: 610-619. doi: 10.1097/SLA.0000000000002957 [40] Mellon EA, Strom TJ, Hoffe SE, et al. Favorable perioperative outcomes after resection of borderline resectable pancreatic cancer treated with neoadjuvant stereotactic radiation and chemotherapy compared with upfront pancreatectomy for resectable cancer[J]. J Gastrointest Oncol, 2016, 7: 547-555. doi: 10.21037/jgo.2016.03.15 [41] Chuong MD, Frakes JM, Figura N, et al. Histopathologic tumor response after induction chemotherapy and stereotactic body radiation therapy for borderline resectable pancreatic cancer[J]. J Gastrointest Oncol, 2016, 7: 221-227. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=5ddb4304-2524-49ec-a677-b3e46055f722 [42] Masui T, DoiR, Kawaguchi Y, et al. Concurrent gemcitabine+S-1 neoadjuvant chemotherapy contributes to the improved survival of patients with small borderline-resectable pancreatic cancer tumors[J]. Surg Today, 2016, 46: 1282-1289. doi: 10.1007/s00595-016-1310-z [43] Ferrone CR, Marchegiani G, Hong TS, et al. Radiological and surgical implications of neoadjuvant treatment with FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer[J]. Ann Surg, 2015, 261: 12-17. doi: 10.1097/SLA.0000000000000867 [44] Blazer M, Wu C, Goldberg RM, et al. Neoadjuvant modified (m) FOLFIRINOX for locally advanced unresectable (LAPC) and borderline resectable (BRPC) adenocarcinoma of the pancreas[J]. Ann Surg Oncol, 2015, 22: 1153-1159. doi: 10.1245/s10434-014-4225-1 [45] Takeda Y, Nakamori S, Eguchi H, et al. Neoadjuvant gemcitabine-based accelerated hyperfractionation chemoradiotherapy for patients with borderline resectable pancreatic adenocarcinoma[J]. Jpn J Clin Oncol, 2014, 44: 1172-1180. doi: 10.1093/jjco/hyu143 [46] Okada KI, Hirono S, Kawai M, et al. Phase I Study of Nab-Paclitaxel plus Gemcitabine as Neoadjuvant Therapy for Borderline Resectable Pancreatic Cancer[J]. Anticancer Res, 2017, 37: 853-858. doi: 10.21873/anticanres.11389 [47] Murphy JE, Wo JY, Ryan DP, et al. Total Neoadjuvant Therapy With FOLFIRINOX Followed by Individualized Chemoradiotherapy for Borderline Resectable Pancreatic Adenocarcinoma: A Phase 2 Clinical Trial[J]. JAMA Oncol, 2018, 4: 963-969. doi: 10.1001/jamaoncol.2018.0329 [48] Peterson SL, Husnain M, Pollack T, et al. Neoadjuvant Nab-paclitaxel and Gemcitabine in Borderline Resectable or Locally Advanced Unresectable Pancreatic Adenocarcinoma in Patients Who Are Ineligible for FOLFIRINOX[J]. Anticancer Res, 2018, 38: 4035-4039. doi: 10.21873/anticanres.12692 [49] Dhir M, Zenati MS, Hamad A, et al. FOLFIRINOX Versus Gemcitabine/Nab-Paclitaxel for Neoadjuvant Treatment of Resectable and Borderline Resectable Pancreatic Head Adenocarcinoma[J]. Ann Surg Oncol, 2018, 25: 1896-1903. doi: 10.1245/s10434-018-6512-8 [50] Macedo FI, Ryon E, Maithel SK, et al. Survival Outcomes Associated With Clinical and Pathological Response Following Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Chemotherapy in Resected Pancreatic Cancer[J]. Ann Surg, 2019, 270: 400-413. doi: 10.1097/SLA.0000000000003468 [51] Nagakawa Y, Hosokawa Y, Nakayama H, et al. A phase Ⅱ trial of neoadjuvant chemoradiotherapy with intensity-modulated radiotherapy combined with gemcitabine and S-1 for borderline-resectable pancreatic cancer with arterial involvement[J]. Cancer Chemother Pharmacol, 2017, 79: 951-957. doi: 10.1007/s00280-017-3288-7 [52] Tienhoven GV, Versteijne E, Suker M, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer (PREOPANC-1): A randomized, controlled, multicenter phase Ⅲ trial[J]. 2018, 36: LBA4002. doi: 10.1200/JCO.2018.36.18_suppl.LBA4002. [53] Nagakawa Y, Sahara Y, Hosokawa Y, et al. Clinical Impact of Neoadjuvant Chemotherapy and Chemoradiotherapy in Borderline Resectable Pancreatic Cancer: Analysis of 884 Patients at Facilities Specializing in Pancreatic Surgery[J]. Ann Surg Oncol, 2019, 26: 1629-1636. doi: 10.1245/s10434-018-07131-8 [54] Cloyd JM, Chen HC, Wang X, et al. Chemotherapy Versus Chemoradiation as Preoperative Therapy for Resectable Pancreatic Ductal Adenocarcinoma: A Propensity Score Adjusted Analysis[J]. Pancreas, 2019, 48: 216-222. doi: 10.1097/MPA.0000000000001231 [55] Truty MJ, Kendrick ML, Nagorney DM, et al. Factors Predicting Response, Perioperative Outcomes, and Survival Following Total Neoadjuvant Therapy for Borderline/Locally Advanced Pancreatic Cancer[J]. Ann Surg, 2019. doi: 10.1097/SLA.0000000000003284. [56] Passardi A, Scarpi E, Neri E, et al. Chemoradiotherapy (Gemox Plus Helical Tomotherapy) for Unresectable Locally Advanced Pancreatic Cancer: A Phase Ⅱ Study[J]. Cancers (Basel), 2019, 11:663. doi: 10.3390/cancers11050663 [57] Li X, Guo CX, Li QH, et al. Association of Modified-FOLFIRINOX-Regimen-Based Neoadjuvant Therapy with Out-comes of Locally Advanced Pancreatic Cancer in Chinese Population[J]. Oncologist, 2019, 24: 301-e393. doi: 10.1634/theoncologist.2018-0696 [58] Murphy JE, Wo JY, Ryan DP, et al. Total Neoadjuvant Therapy With FOLFIRINOX in Combination With Losartan Followed by Chemoradiotherapy for Locally Advanced Pancreatic Cancer: A Phase 2 Clinical Trial[J]. JAMA Oncol, 2019, 5: 1020-1027. doi: 10.1001/jamaoncol.2019.0892 [59] Dholakia AS, Hacker-Prietz A, Wild AT, et al. Resection of borderline resectable pancreatic cancer after neoadjuvant chemoradiation does not depend on improved radiographic appearance of tumor-vessel relationships[J]. J Radiat Oncol, 2013, 2: 413-425. doi: 10.1007/s13566-013-0115-6 [60] Wagner M, Antunes C, Pietrasz D, et al. CT evaluation after neoadjuvant FOLFIRINOX chemotherapy for borderline and locally advanced pancreatic adenocarcinoma[J]. Eur Radiol, 2017, 27: 3104-3116. doi: 10.1007/s00330-016-4632-8 [61] Barreto SG, Loveday B, Windsor JA, et al. Detecting tumour response and predicting resectability after neoadju-vant therapy for borderline resectable and locally advanced pancreatic cancer[J]. ANZ J Surg, 2019, 89: 481-487. doi: 10.1111/ans.14764 [62] Michelakos T, Pergolini I, Castillo CF, et al. Predictors of Resectability and Survival in Patients With Borderline and Locally Advanced Pancreatic Cancer who Underwent Neoadjuvant Treatment With FOLFIRINOX[J]. Ann Surg, 2019, 269: 733-740. doi: 10.1097/SLA.0000000000002600 [63] Aoki S, Motoi F, Murakami Y, et al. Decreased serum carbohydrate antigen 19-9 levels after neoadjuvant therapy predict a better prognosis for patients with pancreatic adenocarcinoma: a multicenter case-control study of 240 patients[J]. BMC Cancer, 2019, 19: 252. doi: 10.1186/s12885-019-5460-4 [64] van Veldhuisen E, Vogel JA, Klompmaker S, et al. Added value of CA19-9 response in predicting resectability of locally advanced pancreatic cancer following induction chemotherapy[J]. HPB (Oxford), 2018, 20: 605-611. doi: 10.1016/j.hpb.2018.01.001 [65] Yokose T, Kitago M, Matsusaka Y, et al. Usefulness of (18) F-fluorodeoxyglucose positron emission tomography/computed tomography for predicting the prognosis and treatment response of neoadjuvant therapy for pancreatic ductal adenocarcinoma[J]. Cancer Med, 2020, 9:4059-4068. doi: 10.1002/cam4.3044 [66] Groot VP, Mosier S, Javed AA, et al. Circulating Tumor DNA as a Clinical Test in Resected Pancreatic Cancer[J]. Clin Cancer Res, 2019, 25: 4973-4984. doi: 10.1158/1078-0432.CCR-19-0197 [67] Tee MC, Krajewski AC, Groeschl RT, et al. Indications and Perioperative Outcomes for Pancreatectomy with Arterial Resection[J]. J Am Coll Surg, 2018, 227: 255-269. doi: 10.1016/j.jamcollsurg.2018.05.001 [68] Del Chiaro M, Rangelova E, Halimi A, et al. Pancreatec-tomy with arterial resection is superior to palliation in patients with borderline resectable or locally advanced pancreatic cancer[J]. HPB (Oxford), 2019, 21: 219-225. doi: 10.1016/j.hpb.2018.07.017 [69] Selvaggi F, Mascetta G, Daskalaki D, et al. Outcome of superior mesenteric-portal vein resection during pancreatectomy for borderline ductal adenocarcinoma: results of a prospec-tive comparative study[J]. Langenbecks Arch Surg, 2014, 399: 659-665. doi: 10.1007/s00423-014-1194-6 [70] Wang W, He Y, Wu L, et al. Efficacy of extended versus standard lymphadenectomy in pancreatoduodenectomy for pancreatic head adenocarcinoma. An update meta-analysis[J]. Pancreatology, 2019, 19: 1074-1080. doi: 10.1016/j.pan.2019.10.003 [71] Tashiro M, Yamada S, Sonohara F, et al. Clinical Impact of Neoadjuvant Therapy on Nutritional Status in Pancreatic Cancer[J]. Ann Surg Oncol, 2018, 25: 3365-3371. doi: 10.1245/s10434-018-6699-8 [72] Marchegiani G, Andrianello S, Nessi C, et al. Neoadjuvant Therapy Versus Upfront Resection for Pancreatic Cancer: The Actual Spectrum and Clinical Burden of Postoperative Complications[J]. Ann Surg Oncol, 2018, 25: 626-637. http://europepmc.org/abstract/MED/29214453 [73] Hank T, Sandini M, Ferrone CR, et al. Association Between Pancreatic Fistula and Long-term Survival in the Era of Neoadjuvant Chemotherapy[J]. JAMA Surg, 2019, 154:943-951. doi: 10.1001/jamasurg.2019.2272 [74] Verma V, Li JL, Lin C. Neoadjuvant Therapy for Pancreatic Cancer: Systematic Review of Postoperative Morbidity, Mortality, and Complications[J]. Am J Clin Oncol, 2016, 39: 302-313. doi: 10.1097/COC.0000000000000278 [75] Roland CL, Katz MH, Tzeng CW, et al. The Addition of Postoperative Chemotherapy is Associated with Improved Survival in Patients with Pancreatic Cancer Treated with Preoperative Therapy[J]. Ann Surg Oncol, 2015, 22 Suppl 3: S1221-S1228. http://www.ncbi.nlm.nih.gov/pubmed/26350371 -
点击查看大图
表(3)
计量
- 文章访问数: 403
- HTML全文浏览量: 82
- PDF下载量: 55
- 被引次数: 0
