中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2014年
2期
138-141
,共4页
欧阳华强%潘战宇(综述)%谢广茹(审校)
歐暘華彊%潘戰宇(綜述)%謝廣茹(審校)
구양화강%반전우(종술)%사엄여(심교)
胰腺癌%肝脏%转移%治疗
胰腺癌%肝髒%轉移%治療
이선암%간장%전이%치료
pancreatic cancer%liver%metastasis%treatment
胰腺癌肝转移（pancreatic cancer with liver metastases，PCLM）为临床难治性恶性肿瘤，其起病隐匿、进展迅速、预后极差，仅极少数患者具有手术机会。全身化疗为主要治疗手段，FOLFIRINOX方案（氟尿嘧啶、奥沙利铂、伊立替康和亚叶酸钙）已成为体能状况良好的PCLM患者的一线化疗方案。以吉西他滨为基础的化疗仍居重要地位，其中吉西他滨联合白蛋白结合型紫杉醇凸显优势，成为PCLM一线化疗的新标准。吉西他滨联合分子靶向治疗的研究暂无新的突破。全身化疗联合经动脉灌注化疗栓塞（transcatheter arterial chemoembolization，TACE）有可能改善PCLM患者的生存率，尚需进一步开展前瞻性的随机对照临床试验加以证实。射频消融（radio frequency ablation，RFA）、近距离放疗栓塞术等尚处探索阶段。基于化疗、放疗与中草药的多学科综合治疗模式方兴未艾。本文就PCLM的治疗进展进行综述。
胰腺癌肝轉移（pancreatic cancer with liver metastases，PCLM）為臨床難治性噁性腫瘤，其起病隱匿、進展迅速、預後極差，僅極少數患者具有手術機會。全身化療為主要治療手段，FOLFIRINOX方案（氟尿嘧啶、奧沙利鉑、伊立替康和亞葉痠鈣）已成為體能狀況良好的PCLM患者的一線化療方案。以吉西他濱為基礎的化療仍居重要地位，其中吉西他濱聯閤白蛋白結閤型紫杉醇凸顯優勢，成為PCLM一線化療的新標準。吉西他濱聯閤分子靶嚮治療的研究暫無新的突破。全身化療聯閤經動脈灌註化療栓塞（transcatheter arterial chemoembolization，TACE）有可能改善PCLM患者的生存率，尚需進一步開展前瞻性的隨機對照臨床試驗加以證實。射頻消融（radio frequency ablation，RFA）、近距離放療栓塞術等尚處探索階段。基于化療、放療與中草藥的多學科綜閤治療模式方興未艾。本文就PCLM的治療進展進行綜述。
이선암간전이（pancreatic cancer with liver metastases，PCLM）위림상난치성악성종류，기기병은닉、진전신속、예후겁차，부겁소수환자구유수술궤회。전신화료위주요치료수단，FOLFIRINOX방안（불뇨밀정、오사리박、이립체강화아협산개）이성위체능상황량호적PCLM환자적일선화료방안。이길서타빈위기출적화료잉거중요지위，기중길서타빈연합백단백결합형자삼순철현우세，성위PCLM일선화료적신표준。길서타빈연합분자파향치료적연구잠무신적돌파。전신화료연합경동맥관주화료전새（transcatheter arterial chemoembolization，TACE）유가능개선PCLM환자적생존솔，상수진일보개전전첨성적수궤대조림상시험가이증실。사빈소융（radio frequency ablation，RFA）、근거리방료전새술등상처탐색계단。기우화료、방료여중초약적다학과종합치료모식방흥미애。본문취PCLM적치료진전진행종술。
Pancreatic cancer with liver metastases (PCLM) is a refractory malignant tumor characterized by insidious onset, rap-id progress, and poor prognosis. Only a few patients had the opportunity of receiving surgical treatment. PCLM is primarily treated by systemic chemotherapy. The chemotherapeutic regimen of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin has become the first-line therapy for PCLM patients with good performance status. Gemcitabine-based chemotherapy is still very important in treating PCLM. Nab-paclitaxel plus gemcitabine, which has been found to increase survival, is recommended as a new standard for treating PCLM patients. However, still no breakthrough has been established in the study of gemcitabine plus molecular-targeted therapy. Sys-temic chemotherapy combined with trans-catheter arterial chemoembolization is valuable and may be effectual in prolonging survival. Further investigation of prospective and randomized controlled clinical trials is necessary. Radio frequency ablation and brachy-thera-peutic embolization with yttrium-90 microspheres are still in the exploratory stage. Multimodality treatment of PCLM using chemother-apy, radiation therapy, and Chinese herbal medicine is gaining wide acceptance. This article reviews the recent progress in the treatment of PCLM.
