胰腺癌的放射治疗:2025年更新
Maxime Bertrand-Chevrier1, Olivier Riou1, Alexandre Orthuon2
1Fédération universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, Institut régional du cancer Montpellier (ICM), Montpellier, France.
概括
法国放射治疗瘤学会的最新建议涉及胰腺癌的放射治疗. 证据表明辅助性化疗可能有利于N0患者,而新辅助方法则提高边缘瘤的切除能力.
科学领域:
- 癌症学
- 辐射瘤学
- 胃肠道瘤学
背景情况:
- 放射治疗在治疗胰腺癌中的作用,无论是切除的还是局部晚期的,仍然是持续争论的主题.
- 目前的标准术后治疗包括6个月的辅助化疗,使用FOLFOXIRI疗法 (5- 甲,甲,甲).
研究的目的:
- 为胰腺癌治疗提供最新的临床建议.
- 澄清胰腺癌不同阶段的各种放射治疗策略的指示和益处.
主要方法:
- 这些建议综合了法国放射性瘤学会 (SFRO) 的现有证据和专家共识.
- 讨论的主要治疗方案包括术后辅助治疗,边缘切除瘤的新辅助治疗,以及局部晚期瘤的最终治疗.
- 对强度调节放射疗法 (IMRT) 和立体放射疗法等先进的放射疗法进行了评估,以评估其潜在的益处和技术考虑.
主要成果:
- 辅助化疗可能对N0胰腺癌患者有好处.
- 诱导化疗后的新辅助化疗可以改善边缘瘤的完全切除率 (R0),尽管生存益处尚未被证明.
- 对于局部晚期的胰腺癌,诱导化疗,然后在非进展的病例中进行化疗,可以提高局部控制和切除能力.
结论:
- 放射治疗在胰腺癌治疗中发挥着微妙的作用,特别是在辅助和新辅助环境中.
- 建议采用IMRT和立体辐射疗法等先进技术,以优化瘤剂量传递,同时不影响有风险的器官,考虑到呼吸运动.
- 需要进一步的研究来确定新辅助化学放射治疗对边缘切除胰腺癌的生存益处.
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