Status of Neoadjuvant Therapy for Resectable Pancreatic Cancer

摘要

Neoadjuvant therapy for patients with localized pancreatic adenocarcinomas was first reported in 1980, in a series of patients treated with radiation therapy alone.1 Of the 17 tumors treated, 15 were declared to be either unresectable or of borderline resect-ability by the surgeon who performed the initial exploratory celiotomy. The intent of the radiation therapy was to increase the resectability rate and to decrease the incidence of local and systemic recurrence. Six of the 17 patients underwent resection, and 2 of those lived for more than 5 years. Conclusions from the results of radiotherapy were that (1) preoperative radiation therapy is feasible and safe, (2) a thorough look for metastatic disease should be undertaken after completion of radiation therapy (because one-third of the patients demonstrated metastases after radiation treatment), and (3) response to radiation therapy should be an important parameter for selecting candidates for resectional surgery. It was also suggested that chemotherapy be tried as a radiation sensitizer.