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There have been many clinical trials conducted to evaluate novel systemic regimens for unresectable pancreatic cancer. However, most of the trial results were negative, and gemcitabine monotherapy has remained the standard systemic treatment for years. A number of molecular targeted agents, including those against epidermal growth factor receptor and vascular endothelial growth factor receptors, have also been tested. In recent years, there have been some breakthroughs in the deadlock:three regimens, namely gemcitabine-erlotinib, FOLFIRINOX, and gemcitabine-nab-paclitaxel, have been shown to prolong the overal survival of patients when compared with gemcitabine monotherapy. In addition, emerging data suggested that the membrane protein human equilibrative nucleotide transporter 1 is a potential biomarker with which to predict the efficacy of gemcitabine. Here we review the literature on the development of systemic agents for pancreatic cancer, discuss the current choices of treatment, and provide future directions on the development of novel agents.
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多层螺旋CT在胰腺癌可切除性评价中的局限
胰腺癌是常见的消化系统恶性肿瘤,其预后很差,目前主要的治疗手段仍为手术切除,但胰腺癌早期诊断困难,手术切除率低,如果能在术前对胰腺癌进行可切除性评估,具有重要的意义.自2002-03-2005-09,我们对26例胰腺癌病人进行术前多层螺旋CT扫描并与手术探查和术后病理结果进行对照研究,分析多层螺旋CT在胰腺癌病人术前评价肿瘤可切除性的准确率以及局限性.
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进展期胰腺癌的综合治疗进展
胰腺癌是常见的消化道恶性肿瘤之一,虽只占癌症的2%~3%,却有极高的死亡率.原因在于确诊时往往已进入进展期,手术切除率仅20%,预后极差,85%的患者在诊断后1年内死亡.治疗方法包括手术、放化疗、核素、物理、基因、免疫等,有效的治疗是以手术为主,辅以其他综合治疗手段.近年来胰腺癌干细胞的发现也为将来的治疗开辟出新的道路.
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放射性粒子治疗胰腺癌的术前准备与术后处理
目前国内多家医院开展了放射性粒子组织间植入治疗胰腺癌,取得了令人瞩目的成绩,患者生存期延长,生活质量提高[1,2].放射性粒子治疗胰腺癌的微创优势使更多患者及家属乐于接受,但各家医院进行放射性粒子治疗胰腺癌的过程中其术前准备和术后处理各不相同,使治疗全过程出现了一些可避免的风险.