locally advanced pancreatic cancer- current therapeutic approach.docVIP

Locally Advanced Pancreatic Cancer: Current Therapeutic Approach nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;作者：Higinia R. Cardenesa, Elena G. Chioreanb, John DeWittc, Max Schmidtd, Patrick Loehrerbnbsp;nbsp;nbsp;nbsp;nbsp;nbsp; 【关键词】nbsp; Pancreatic,cancer nbsp; Key Words. Pancreatic cancer ; Locally advanced disease ; Chemoradiotherapy ; Surgery ; Molecular targeted therapy nbsp; ABSTRACT nbsp; Even though pancreatic cancer accounts for only 2% of all cancer diagnoses in the U.S., it is the fourth-leading cause of cancer death and one of the most difficult malignancies to manage. Because of the usually late onset of symptoms, only 10%15% of patients present with resectable disease, whereas the remaining 85%90% present with locally advanced unresectable or metastatic disease. Despite a lack of consistent evidence from previous clinical trials, chemotherapy in addition to radiation therapy is the most commonly used approach in treating locally advanced pancreatic cancer. The most appropriate chemotherapy in combination with radiation is still debatable between 5-fluorouracil and gemcitabine, and novel trends to prevent resistance and enhance efficacy incorporate biologically targeted agents. This paper reviews the current management options, controversies, and ongoing and future directions for the treatment of locally advanced adenocarcinoma of the pancreas. nbsp; INTRODUCTION nbsp; The American Cancer Society estimated that there would be 32,180 new cases of pancreatic cancer (PC) in the U.S. in 2005 and 31,800 deaths, representing the fourth most common cause of cancer mortality [1]. Despite continuing advances in diagnostic imaging and staging, improvements in radiation therapy techniques, and availability of new systemic therapies, the survival and mortality from PC have remained relatively constant. For all stages combined, the 1-year survival rate is around 20%, and the overall 5-year survival rate has rem