期刊
FRONTIERS IN ONCOLOGY
卷 11, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2021.744161
关键词
resectable pancreatic cancer (RPC); borderline resectable pancreatic cancer (BRPC); chemotherapy; radiotherapy; neoadjuvant treatment
类别
There is a global shift towards a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer. Randomized studies show that neoadjuvant chemotherapy or chemoradiotherapy improves overall survival. However, more effective chemotherapy regimens, such as FOLFIRINOX and Gemcitabine/Nab-paclitaxel, should be investigated in combination with radiotherapy to further improve outcomes.
Worldwide, there is a shifting paradigm from immediate surgery with adjuvant treatment to a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer (RPC or BRPC). Comparison of neoadjuvant and adjuvant studies is extremely difficult because of a great difference in patient selection. The evidence from randomized studies shows that overall survival by intention-to-treat improves after neoadjuvant gemcitabine-based chemoradiotherapy or chemotherapy (various regimens), as compared to immediate surgery followed by adjuvant chemotherapy. Radiotherapy appears to play an important role in mediating locoregional effects. Yet, since more effective chemotherapy regimens are currently available, in particular FOLFIRINOX and Gemcitabine/Nab-paclitaxel, these chemotherapy regimens should be investigated in future randomized trials combined with (stereotactic) radiotherapy to further improve outcomes of RPC and BRPC.
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