2011版《NCCN胰腺癌临床实践指南》中若干问题的探讨

刘子文; 赵玉沛

2011版《NCCN胰腺癌临床实践指南》中若干问题的探讨

北京协和医院基本外科

详细信息

中图分类号: R735.9
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出版历程
- 收稿日期: 2011-09-13
- 出版日期: 2011-11-20

The discussion on the issues related to NCCN clinical practice guidelines in oncology for pancreatic adenocarcinoma (V2011)

摘要

摘要: 《NCCN胰腺癌临床实践指南》2011中国版已修订完成,新版指南在原有内容基础上结合近年来临床研究进展,在胰腺癌的诊断和治疗路线、原则、循证医学证据上进行了细微更新,并在理念上有了新的阐述,本文就更新中的相关问题进行探讨。《NCCN胰腺癌临床实践指南》2011版中针对胰腺癌的诊断提出了多学科评估的理念,治疗上重视肿瘤可切除性判定标准,化疗中对于体力状态好的患者可选用FOLFIRINOX方案,强调了吉西他滨和5-氟尿嘧啶（5-FU）均作为胰腺癌化疗的I类证据。
- 胰腺肿瘤 /
- 诊疗准则
Abstract: The revision of the Chinese version of NCCN clinical practice guidelines in oncology for pancreatic adenocarcinoma (V2011) has been completed.Based on the clinical research in recent years, the new version of the guidelines expressed new ideas and made minor updates on the diagnosis, treatment, and evidence based medicine of pancreatic adenocarcinoma.This article discusses issues related to these new updates.NCCN pancreatic adenocarcinoma guidelines (V2011) presented the concept of multidisciplinary review and emphasized the criteria defining resectability status in treatment.In addition, greater emphasis was placed on the principles of chemotherapy.FOLFIRINOX therapy was recommended for patients in good physical condition.Gemcitabine and 5-FU were also highlighted as Category 1 evidence for chemotherapy of pancreatic adenocarcinoma.
- pancreatic neoplasms /
- practice guideline

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参考文献(14)

[1]Callery MP, Chang KJ, Fishman EK, et al.Pretreatment as-sessment of resectable and borderline resectable pancreaticcancer:expert consensus statement[J].Ann Surg Oncol, 2009, 16 (7) :1727-1733.

[2]Klauss M, Schobinger M, Wolf I, et al.Value of three-di-mensional reconstructions in pancreatic carcinoma using mul-tidetector CT:initial results[J].World J Gastroenterol, 2009, 15 (46) :5827-5832.

[3]McNulty NJ, Francis IR, Platt JF, et al.Multi——detectorrow helical CT of the pancreas:effect of contrast-enhancedmultiphasic imaging on enhancement of the pancreas, peripancreatic vasculature, and pancreatic adenocarcinoma[J].Radiology, 2001, 220 (1) :97-102.

[4]Farma JM, Santillan AA, Melis M, et al.PET/CT fusion scanenhances CT staging in patients with pancreatic neoplasms[J].Ann Surg Oncol, 2008, 15 (9) :2465-2471.

[5]Varadarajulu S, Wallace MB.Applications of endoscopic ul-trasonography in pancreatic cancer[J].Cancer Control, 2004, 11 (1) :15-22.

[6]Ahmed SI, Bochkarev V, Oleynikov D, et al.Sasson AR.Patients with pancreatic adenocarcinoma benefit from staginglaparoscopy[J].J Laparoendosc Adv Surg Tech A, 2006, 16 (5) :458-463.

[7]Birkmeyer JD, Siewers AE, Finlayson EV, et al.Hospital vol-ume and surgical mortality in the United States[J].N Engl JMed, 2002, 346 (15) :1128-1137.

[8]Bilimoria KY, Bentrem DJ, Ko CY, et al.Multimodality thera-py for pancreatic cancer in the U.S.:utilization, outcomes, and the effect of hospital volume[J].Cancer, 2007, 110 (6) :1227-1234.

[9]Neoptolemos JP, Stocken DD, Bassi C, et al.Adjuvant chemo-therapy with fluorouracil plus folinic acid vs gemcitabine follow-ing pancreatic cancer resection:a randomized controlled trial[J].JAMA, 2010, 304 (10) :1073-1081.

[10]Van Laethem JL, Hammel P, Mornex F, et al.Adjuvantgemcitabine alone versus gemcitabine-based chemoradio-therapy after curative resection for pancreatic cancer:a ran-domized EORTC-40013-22012/FFCD-9203/GERCORphase II study[J].J Clin Oncol, 2010, 28 (29) :4450-4456.

[11]Murphy JD, Adusumilli S, Griffith KA, et al.Full-dose gemcit-abine and concurrent radiotherapy for unresectable pancreaticcancer[J].Int J Radiat Oncol Biol Phys, 2007, 68 (3) :801-808.

[12]Ychou M, Conroy T, Seitz JF, et al.An open phase I studyassessing the feasibility of the triple combination:oxaliplatin plus irinotecan plus leucovorin/5-fluorouracil every 2 weeksin patients with advanced solid tumors[J].Ann Oncol, 2003, 14 (3) :481-489.

[13]Conroy T, Desseigne F, Ychou M, et al.Randomized phaseIII trial comparing FOLFIRINOX (F:5FU/leucovorin[LV], iri-notecan[I], and oxaliplatin[O]) versus gemcitabine (G) as first-line treatment for metastatic pancreatic adenocarci-noma (MPA) :Preplanned interim analysis results of the PRODIGE 4/ACCORD 11 trial[J].J Clin Oncol, 2010, 28 (15suppl) :4010.

[14]Finkelberg DL, Sahani D, Deshpande V, et al.Autoimmunepancreatitis[J].N Engl J Med, 2006, 355:2670-2676.

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