胰腺癌诊治指南ppt课件.ppt

化疗和放疗 术前及术后化疗、放疗存在争议 与5-FU相比，吉西他滨在提高生存质量方面略显优势 分子靶向药物的疗效正在评估中 放疗：术前放疗、术中放疗、适形调强放疗、放射性核素内照射治疗和放化疗 综合治疗 J Clin Oncol 2007;25:1960-1966. JAMA 2007;297:267-277. Cancer 1981;48:1705-1710. N Engl J Med 2004;350:1200-1210. Ann Surg 1999;230:776-784. 综合治疗 其它辅助治疗 包括：射频组织灭活，冷冻，高能聚焦超声，γ－刀及生物治疗等 目前没有明确证据显示其能够延长生存期 影像学检查 肿瘤标志物检测 综合治疗 随 访 高危人群 继续随访 绿色通道 可切除性评估 可切除 不可切除 根治性手术 组织病理活检 确定诊断 排除诊断 姑息治疗 放、化疗 胰腺癌诊治流程 * Semin Oncol. 1996 Apr;23(2):251-75. Familial pancreatic cancer: a review. Lynch HT, Smyrk T, Kern SE, This review addresses the genetic epidemiology of pancreatic cancer and updates our views on screening, surgery, chemotherapy, and genetic counseling, all of which must be used to gain value from genetic predictability of risk status. J Clin Gastroenterol. 1989 Apr;11(2):211-5. New-onset diabetes mellitus as a harbinger of pancreatic carcinoma. A case report and literature review. Rosa JA, Van Linda BM, Abourizk NN. We review the literature on the relationship between diabetes mellitus and pancreatic carcinoma with particular emphasis on situations in which recent-onset diabetes may be a harbinger of pancreatic carcinoma. N Engl J Med. 1993 May 20;328(20):1433-7. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. Lowenfels AB, Maisonneuve P, Cavallini G, CONCLUSIONS. The risk of pancreatic cancer is significantly elevated in subjects with chronic pancreatitis and appears to be independent of sex, country, and type of pancreatitis. * J Natl Cancer Inst. 1994 Oct 19;86(20):1510-6 Cigarette smoking and pancreas cancer: a case-control study based on direct interviews. Silverman DT, Dunn JA, Hoover RN, CONCLUSIONS: The relationship between cigarette smoking and pancreas cancer risk is likely to be causal, despite the weakness of the dose-response data. Long-term smoking cessation clearly reduces risk, whereas switching from nonfiltered to filtered cigarettes may not be beneficial. Cigarette smoking appears to explain little