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晚期胰腺癌的化疗和放射治疗
Lucy Haggstrom1,2,3, Wei Yen Chan1,4, Adnan Nagrial5,6
1Medical Oncology, The Kinghorn Cancer Care Centre, St Vincent's Hospital, Sydney, Australia.
这次对晚期胰腺癌治疗的审查发现,组合化疗,包括FOLFIRINOX和凝胺加上一个纳税剂,与单独的凝胺相比,改善了整体存活率. 生物标志物开发对于个性化治疗选择至关重要.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 基于证据的医学基于证据的医学.
背景情况:
- 胰腺癌 (PC) 是一种高度致命的恶性瘤,有效的治疗选择有限.
- 本综述综合了随机试验数据,以告知高级PC的治疗决策.
- 它作为2018年版本的更新,结合了最新的研究.
研究的目的:
- 为了评估化疗,放射治疗或联合治疗对晚期胰腺癌的第一线治疗的疗效.
- 评估对整体存活时间,严重不良事件和生活质量的影响.
- 为临床决策提供最新的证据基础.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库 (CENTRAL,MEDLINE,Embase,CANCERLIT) 和手动搜索到2023年7月的来源.
- 包括75项研究 (51项在元分析中),涉及11,333名患有局部晚期或转移性胰腺癌的参与者.
主要成果:
- 化疗与最佳支持性护理相比,整体存活率 (OS) 的差异很小.
- 与单独使用gemcitabine相比,FOLFIRINOX和gemcitabine加上一个税素显著改善了OS.
- 基于皮里米丁的组合化疗改善了与凝心素加纳布-帕克利塔塞尔相比的生存状况;放射治疗的影响仍然不确定.
结论:
- 组合化疗是转移性胰腺癌的标准治疗方法.
- 福利诺克斯 (FOLFIRINOX) 和吉姆西塔-塔 (gemcitabine-taxane) 组合比吉姆西塔 (gemcitabine) 提供了更好的操作系统.
- 个性化治疗选择需要进一步开发生物标志物.
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