Neoadjuvant chemotherapy for pancreatic cancer, mentioned several times in front of us, including the film adenocarcinoma , including many in the advanced tumor resection rate is very low. Currently that only surgery can get the best out of the efficacy of the tumor, can we create conditions for surgical removal of it? Lesions using a variety of methods to reduce the idea of which one is that neoadjuvant therapy. Put forward the concept is the concept of cancer surgeons and physicians on a challenge. People according to the experience of adjuvant therapy neoadjuvant treatment concept, also known as neoadjuvant therapy, including neoadjuvant chemotherapy, neoadjuvant radiotherapy and neoadjuvant chemotherapy.
New theoretical basis for adjuvant therapy: surgical resection of primary tumor may stimulate the growth of remaining tumor cells. tissue around the tumor after surgery the blood supply to certain changes occurred, some vascular interruption, atresia or stenosis, drug concentration and effect of chemotherapy. response to the situation of neoadjuvant therapy can be used to guide the prognosis of patients, histopathology, response and prognosis of patients with a positive correlation. patients after neoadjuvant therapy may improve the condition, stage of disease decreased, so as to achieve the purpose of improving the rate of surgical resection. neoadjuvant therapy can reduce the spread of the possibility of surgery. advanced cancer are all systemic disease, systemic chemotherapy can eliminate micrometastases potential to reduce the possibility of metastasis and recurrence after surgery. If the new element effective adjuvant therapy, adjuvant chemotherapy after surgery for poor results are inevitable, from this perspective, neoadjuvant therapy can not exclude surgery patients can also learn about the tumor response to therapy, identify patients at surgery whether the need to continue treatment. In view of these considerations, the new adjuvant chemotherapy in the treatment of solid tumors played a very important role.
Neoadjuvant chemotherapy for pancreatic cancer, the concept of neoadjuvant therapy is made from a surgical point of view. The main purpose of chemotherapy is to improve the removal rate, removal of the tumor can not be the original reduced by chemotherapy after resection. 2 Yi, and should not be removed for unresectable adenocarcinoma of the two concepts. "Can not be removed" in English, called the "unable", that is to achieve the established objectives can achieve better results, but for some reason can not achieve that goal; "unsuitable" is not removed, that will not achieve the desired goals more good results. Pancreatic cancer preoperative chemotherapy for unresectable primary and treatment for the present there is hope after resection. We lesion was local invasion, local involvement of vital organs or structures were called "locally advanced tumors." Locally advanced adenocarcinoma of the film refers to tumor invasion of the main superior mesenteric artery, superior mesenteric vein or portal vein beginning part of those remaining after removal of the lesion reduced the opportunity, and if the lesion further development of the violation of the common bile duct, abdominal aorta and other structures, surgery When the detectors mostly frozen samples can not be separated, this time even if complete resection of the results would be poor. Of course, with widespread metastasis of tumor removal is not part of the column. Chemotherapy before surgery as with ordinary chemotherapy, patients need to understand the general condition, such as the liver, dirty, bone marrow function and nutritional status of patients. Another important point, as I get informed consent of patients to the diagnosis and treatment in the future to better match the process, but also conducive to achieve better results.
Readers are most concerned about are often the best solution, the best treatment, best doctors, and so, in fact, there said it best "There is no best, only better." Treatment of adenocarcinoma of the film is also the case. Less effective as a treatment for cancer, including doctors, researchers and patients are struggling to find a better solution. Therefore, within the framework of international clinical trials of numerous. Do this disgusting, immoral, or that "how it could get people to do experiments?" On the one hand, all clinical studies have been informed patient or guardian consent, the participants are willing to accept this kind of research I treatment; the other hand, the existence of such in medical history to some studies, the use of dozens or even a hundred years later found that more harm than good, while the rush against, because most of the studies is that early studies are reviewed, and sometimes can not remove some interfering factors. At present, often large-scale randomized controlled clinical trial is to come to the conclusion authentic, including some volunteers, patients and doctors of science in the development and rehabilitation of patients to make their own contribution.
Neoadjuvant chemotherapy for pancreatic cancer, the film mode of the neoadjuvant treatment of cancer include chemotherapy and radiotherapy and chemotherapy combination. After a maximum, the effect is better than the former. Very uniform treatment, radiotherapy dose 50.4Gy, 40Gy, etc. according to different partition, select 5 fluorouracil chemotherapy drugs a little hospital, a cool leucovorin) an anti-white, gemcitabine, etc. Overall, the effect is similar, studies suggest that even no benefits. American Cancer Center MD Anderson Cancer Center in 142 patients with local cancer patients with resectable membrane research, treatment options include two: one before surgery and then radiotherapy 50.4Gy/180cGy/f or 30Gy/10Gy/f surgery. Postoperative intravenous infusion of 5-Fu given P the other group first surgery, then radiotherapy and chemotherapy. Observed 19 months later, the situation between the two groups were not significantly different survival. In view of this, to wait several recent clinical studies began only after evaluation of the results came out.