不同类型胰腺癌的治疗策略.PDFVIP

中国普外基础与临床杂志 2019 年8 月第26 卷第8 期 • 1011 •   ·综　述 · 不同类型胰腺癌的治疗策略 彭洋，孙韶龙 中国医科大学附属盛京医院胰腺内分泌外科（沈阳  110004 ） 【摘要】   目的    探讨不同类型胰腺癌的治疗策略。方法    通过阅读近几年国内外胰腺癌治疗的相关文献， 对胰腺癌的分类及其治疗措施的进展进行归纳总结。结果    依据术前影像学评估将胰腺癌分为可切除胰腺癌、交 界可切除胰腺癌、局部进展期胰腺癌和合并远处转移的胰腺癌。可切除胰腺癌应行根治性切除，术后辅以化疗。 交界可切除胰腺癌患者中，静脉受侵若能够切除重建，主张行手术治疗，术后行辅助化疗；对于静脉受侵不可切 除重建及动脉受侵的患者，应行新辅助治疗，然后对肿瘤的可切除性进行重新评估，明确是否可行手术治疗。局 部进展期或合并转移的胰腺癌患者多已失去手术时机，多主张行新辅助放化疗或二线联合靶向治疗。结论    大 多数胰腺癌患者就诊时肿瘤已进入进展期，熟悉掌握胰腺癌的类型，采取针对性的治疗措施，可改善患者的生 存时间。 【关键词】  胰腺癌；分类；辅助治疗；新辅助治疗；综述 Treatment strategies for different types of pancreatic cancer PENG Yang, SUN Shaolong Department of Pancreatic Endocrinology, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, P. R. China Corresponding author: SUN Shaolong, Email: unsl@ 【Abstract 】 Objective    To explore the treatment strategies of different types of pancreatic cancer. Methods    By reading the relevant literatures on the treatment of pancreatic cancer at home and abroad in recent years, the classification of pancreatic cancer and the progress of treatment measures were summarized. Results    According to preoperative imaging evaluation, pancreatic cancer was divided into resectable pancreatic cancer, borderline resectable pancreatic cancer, locally advanced pancreatic cancer, and pancreatic cancer with distant metastasis. Resection of pancreatic cancer should be radical resection, supplemented with chemotherapy after surgery; patients with resected pancreatic cancer in the junction, if the patient with venous invasion could be resected and reconstructed, it was recommended to undergo surgery and postoperative adjuvant chemotherapy. Patients with unresectable reconstruction and arterial invasion should undergo neoadju