Медицинская литература. Новинки

 

 

 

 

 

 

Неоадъювантная химиотерапия при резектабельном раке поджелудочной железы – новый стандарт лечения?

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Цель. Оценка места неоадъювантной химиотерапии при резектабельном раке поджелудочной железы по результатам рандомизированных клинических исследований и метаанализов. Материал и методы. Для поиска литературы использовали базы данных PubMed, Сochrane, EMBASE, GoogleScholar. Ключевые слова MESH “neoadjuvant therapy” в комбинации со словосочетаниями “pancreatic cancer”, “resectable”, “pancreaticoduodenectomy”. Результаты. В начале XXI века представление о биологии рака поджелудочной железы изменилось, и даже на ранних стадиях, при малом размере, отсутствии поражения лимфоузлов опухоль следует считать системным заболеванием. Одним из актуальных вопросов является необходимость применения неоадъювантной полихимиотерапии у больных резектабельными опухолями. Получены доказательства эффективности и безопасности метода. Однако остается ряд вопросов, на которые ответы еще не получены. Станет ли неоадъювантная полихимиотерапия у больных резектабельным раком поджелудочной железы новым достижением химиотерапии и стандартом лечения – вопрос будущих клинических исследований. Заключение. Неоадъювантная полихимиотерапия у больных резектабельным раком поджелудочной железы – перспективный метод лечения, способный улучшить онкологические результаты лечения. Вместе с тем доказательств этому в настоящее время недостаточно.

Ключевые слова:
рак поджелудочной железы, неоадъювантная химиотерапия, резектабельный рак, полихимиотерапия, химиолучевая терапия, отдаленные результаты

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Neoadjuvant chemotherapy for resectable pancreatic cancer: a new standard of care?

Aim. To evaluate the potential of neoadjuvant chemotherapy in resectable pancreatic cancer based on the results of randomized clinical trials and meta-analyses. Materials and methods. PubMed, Сochrane, EMBASE, GoogleScholar databases were used for bibliographic search with keywords MESH “neoadjuvanttherapy” in combination with “pancreaticcancer”, “resectable”, “pancreaticoduodenectomy”. Results. At the beginning of the 21st century the understanding of pancreatic cancer biology changed. A tumor should be considered a systemic disease even in its early stages, with small size and without lymph node involvement. The necessity for application of neoadjuvant polychemotherapy in patients with resectable tumors is an important issue. The efficacy and safety of the method has been proved. However, a number of questions are still to be answered. Whether neoadjuvant polychemotherapy in patients with resectable pancreatic cancer will be a new achievement of chemotherapy and the standard of care is a matter for future clinical research. Conclusion. Neoadjuvant polychemotherapy in patients with resectable pancreatic cancer is a promising therapy that can improve oncological outcomes of treatment. However, the evidence for this argument is currently insufficient.

Keywords:
pancreatic cancer, neoadjuvant chemotherapy, resectable cancer, polychemotherapy, chemoradiation, long-term results