Neoadjuvant Treatment for Resectable and Borderline Resectable Pancreatic Cancer: Chemotherapy or Chemoradiotherapy?

Frontiers in Oncology

Marjolein Y. V. Homs¹  Joost M. Klaase²  Judith de Vos-Geelen³  Johanna W. Wilmink⁴  Geertjan van Tienhoven⁵  Eva Versteijne⁵  Martijn P. W. Intven⁶  Ignace H. J. T. de Hingh⁷  Hjalmar C. van Santvoort⁸ 

[1] Department Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, Netherlands;Department of Hepatopancreatobiliary Surgery and Liver Transplantation, University Medical Center Groningen, Groningen, Netherlands;Department of Internal Medicine, Division of Medical Oncology, GROW—School for Oncology and Developmental Biology, Maastricht University Medical Center (UMC+), Maastricht, Netherlands;Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, Netherlands;Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, Netherlands;Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands;Department of Surgery, Catharina Hospital, Eindhoven and GROW—School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands;Department of Surgery, Regionaal Academisch Kankercentrum Utrecht (RAKU), St Antonius Hospital, Nieuwegein, Netherlands;

关键词: resectable pancreatic cancer (RPC);    borderline resectable pancreatic cancer (BRPC);    chemotherapy;    radiotherapy;    neoadjuvant treatment;   

DOI  :  10.3389/fonc.2021.744161

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown