局限期胰腺癌放化疗的临床试验研究进展

doi:10.3760/cma.j.cn113030-20200407-00165

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Pancreatic cancer is technically divided into surgically resectable, borderline resectable or unresectable disease according to the relationship between tumor mass and adjacent blood vessels. Upon diagnosis, most of the lesions have been locally advanced or had distant metastases,and only 20% of the patients have the opportunity for tumor resection. Radiotherapy and chemotherapy are essential for pancreatic cancer. In this article, the literatures published in recent years were reviewed to focus on the research progress on the clinical trials of neoadjuvant radiochemotherapy, stereotactic body radiation therapy (SBRT), radiochemotherapy combined with immunotherapy for localized pancreatic cancer.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Chen Lining
	Tang Yuan
	Jin Jing

Key words： Pancreatic neoplasm/radiochemotherapy Pancreatic neoplasm/immunotherapy Research progress

Received: 07 April 2020

Corresponding Authors: Jin Jing, Email:jinjing@csco.org.cn

Cite this article:

Chen Lining,Tang Yuan,Jin Jing. Research progress on clinical trials of radiaotherapy and chemotherapy in localized pancreatic cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(12): 1326-1329.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20200407-00165 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I12/1326

[1] American Cancer Society. Cancer facts&figures 2018[M]. GA:Atlanta, 2018.
[2] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017[J]. CA Cancer J Clin, 2017, 67(1):7-30. DOI:10.3322/caac.21387.
[3] Rahib L, Smith BD, Aizenberg R, et al. Projecting cancer incidence and deaths to 2030:the unexpected burden of thyroid, liver, and pancreas cancers in the United States[J]. Cancer Res, 2014, 74(11):2913-2921. DOI:10.1158/0008-5472.can-14-0155.
[4] Kamisawa T, Wood LD, Itoi T, et al. Pancreatic cancer[J]. Lancet, 2016, 388(10039):73-85. DOI:10.1016/s0140-6736(16)00141-0.
[5] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132. DOI:10.3322/caac.21338.
[6] Gillen S, Schuster T, Meyer Z, et al. Preoperative/neoadjuvant therapy in pancreatic cancer:a systematic review and meta-analysis of response and resection percentages[J]. PLoS Med, 2010, 7(4):e1000267. DOI:10.1371/journal.pmed.1000267.
[7] Schorn S, Demir IE, Reyes CM, et al. The impact of neoadjuvant therapy on the histopathological features of pancreatic ductal adenocarcinoma-A systematic review and meta-analysis[J]. Cancer Treat Rev, 2017, 55:96-106. DOI:10.1016/j.ctrv.2017.03.003.
[8] Roland CL, Yang AD, Katz MH, et al. Neoadjuvant therapy is associated with a reduced lymph node ratio in patients with potentially resectable pancreatic cancer[J]. Ann Surg Oncol, 2015, 22(4):1168-1175. DOI:10.1245/s10434-014-4192-6.
[9] Piperdi M, McDade TP, Shim JK, et al. A neoadjuvant strategy for pancreatic adenocarcinoma increases the likelihood of receiving all components of care:lessons from a single-institution database[J]. HPB (Oxford), 2010, 12(3):204-210. DOI:10.1111/j.1477-2574.2009.00150.x.
[10] Pipas JM, Zaki BI, McGowan MM, et al. Neoadjuvant cetuximab, twice-weekly gemcitabine, and intensity-modulated radiotherapy (IMRT) in patients with pancreatic adenocarcinoma[J]. Ann. Oncol, 2012, 23(11):2820-2827. DOI:10.1093/annonc/mds109.
[11] Kim EJ, Ben-Josef E, Herman JM, et al. A multi-institutional phase 2 study of neoadjuvant gemcitabine and oxaliplatin with radiation therapy in patients with pancreatic cancer[J]. Cancer, 2013, 119(15):2692-2700. DOI:10.1002/cncr.28117.
[12] Takahashi S, Ohno I, Ikeda M, et al. Neoadjuvant S-1 with concurrent radiotherapy followed by surgery for borderline resectable pancreatic cancer:study protocol for an open-label, multicentre, prospective phase Ⅱ trial (JASPAC05)[J]. BMJ Open, 2017, 7(10):e018445. DOI:10.1136/bmjopen-2017-018445.
[13] Golcher H, Brunner TB, Witzigmann H, et al. Neoadjuvant chemoradiation therapy with gemcitabine/cisplatin and surgery versus immediate surgery in resectable pancreatic cancer:results of the first prospective randomized phase Ⅱ trial[J]. Strahlenther Onkol, 2015, 191(1):7-16. DOI:10.1007/s00066-014-0737-7.
[14] Katz MH, Shi Q, Ahmad SA, et al. Preoperative modified FOLFIRINOX treatment followed by capecitabine-based chemoradiation for borderline resectable pancreatic cancer:alliance for clinical trials in oncology trial A021101[J]. JAMA Surg, 2016, 151(8):e161137. DOI:10.1001/jamasurg.2016.1137.
[15] Versteijne E, Suker M, Groothuis K, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer:results of the dutch randomized phase Ⅲ PREOPANC trial[J]. J Clin Oncol, 2020, 38(16):1763-1773. DOI:10.1200/JCO.19.02274.
[16] Trakul N, Koong AC, Chang DT. Stereotactic body radiotherapy in the treatment of pancreatic cancer[J]. Semin Radiat Oncol, 2014, 24(2):140-147. DOI:10.1016/j.semradonc.2013.11.008.
[17] Chang DT, Schellenberg D, Shen J, et al. Stereotactic radiotherapy for unresectable adenocarcinoma of the pancreas[J]. Cancer, 2009, 115(3):665-672. DOI:10.1002/cncr.24059.
[18] Schellenberg D, Goodman KA, Lee F, et al. Gemcitabine chemotherapy and single-fraction stereotactic body radiotherapy for locally advanced pancreatic cancer[J]. Int J Radiat Oncol Biol Phys, 2008, 72(3):678-686. DOI:10.1016/j.ijrobp.2008.01.051.
[19] Herman JM, Chang DT, Goodman KA, et al. Phase 2 multi-institutional trial evaluating gemcitabine and stereotactic body radiotherapy for patients with locally advanced unresectable pancreatic adenocarcinoma[J]. Cancer, 2015, 121(7):1128-1137. DOI:10.1002/cncr.29161.
[20] Mellon EA, Hoffe SE, Springett GM, et al. Long-term outcomes of induction chemotherapy and neoadjuvant stereotactic body radiotherapy for borderline resectable and locally advanced pancreatic adenocarcinoma[J]. Acta Oncol, 2015, 54(7):979-985. DOI:10.3109/0284186X.2015. 1004367.
[21] Petrelli F, Comito T, Ghidini A, et al. Stereotactic body radiation therapy for locally advanced pancreatic cancer:a systematic review and pooled analysis of 19 trials[J]. Int J Radiat Oncol Biol Phys, 2017, 97(2):313-322. DOI:10.1016/j.ijrobp.2016.10.030.
[22] Zhong J, Patel K, Switchenko J, et al. Outcomes for patients with locally advanced pancreatic adenocarcinoma treated with stereotactic body radiation therapy versus conventionally fractionated radiation[J]. Cancer, 2017, 123(18):3486-3493. DOI:10.1002/cncr.30706.
[23] Pollom EL, Alagappan M, von Eyben R, et al. Single-versus multifraction stereotactic body radiation therapy for pancreatic adenocarcinoma:outcomes and toxicity[J]. Int J Radiat Oncol Biol Phys, 2014, 90(4):918-925. DOI:10.1016/j.ijrobp.2014.06.066.
[24] 任刚,夏廷毅. 胰腺癌放疗剂量模式改变的研究进展[J]. 中华结直肠疾病电子杂志,2016, 5(2):121-126.
Ren G, Xia TY. Research progress of radiotherapy dose pattern changes for pancreatic cancer[J]. Chin J Colorec Dis (Elec Ed), 2016, 5(2):121-126.
[25] 夏廷毅,孙庆选,于涌,等. 体部γ刀治疗52例胰腺癌的疗效分析[J]. 中华肝胆外科杂志, 2006, 12(2):86-88. DOI:10.3760/cma.j.issn.1007-8118.2006.02.006.
Xia TY, Sun QX, Yu Y, et al. Efficacy of body gamma knife in the treatment of 52 cases of pancreatic cancer[J]. Chin J Hepatobiliary Surg, 2006, 12(2):86-88. DOI:10.3760/cma.j.issn.1007-8118.2006.02.006.
[26] Katz MHG, Ou FS, Herman JM, et al. Alliance for clinical trials in oncology (ALLIANCE) trial A021501:preoperative extended chemotherapy vs. chemotherapy plus hypofractionated radiation therapy for borderline resectable adenocarcinoma of the head of the pancreas[J]. BMC Cancer, 2017, 17(1):505. DOI:10.1186/s12885-017-3441-z.
[27] Blair AB, Rosati LM, Rezaee N, et al. Postoperative complications after resection of borderline resectable and locally advanced pancreatic cancer:The impact of neoadjuvant chemotherapy with conventional radiation or stereotactic body radiation therapy[J]. Surgery, 2018, 163(5):1090-1096. DOI:10.1016/j.surg.2017.11.027.
[28] Tozzi A, Comito T, Alongi F, et al. SBRT in unresectable advanced pancreatic cancer:preliminary results of a mono-institutional experience[J]. Radiat Oncol, 2013, 8:148. DOI:10.1186/1748-717x-8-148.
[29] Comito T, Cozzi L, Clerici E, et al. Can stereotactic body radiation therapy be a viable and efficient therapeutic option for unresectable locally advanced pancreatic adenocarcinoma? Results of a phase 2 study[J]. Technol Cancer Res Treat, 2017, 16(3):295-301. DOI:10.1177/1533034616650778.
[30] Sharabi AB, Lim M, DeWeese TL, et al. Radiation and checkpoint blockade immunotherapy:radiosensitisation and potential mechanisms of synergy[J]. Lancet Oncol, 2015, 16(13):e498-509. DOI:10.1016/s1470-2045(15)00007-8.
[31] Granier C, De Guillebon E, Blanc C, et al. Mechanisms of action and rationale for the use of checkpoint inhibitors in cancer[J]. ESMO Open, 2017, 2(2):e000213. DOI:10.1136/esmoopen-2017-000213.
[32] Kaplan DH, Shankaran V, Dighe AS, et al. Demonstration of an interferon gamma-dependent tumor surveillance system in immunocompetent mice[J]. Proc Natl Acad Sci USA, 1998, 95(13):7556-7561. DOI:10.1073/pnas.95.13.7556.
[33] Dunn GP, Sheehan KC, Old LJ, et al. IFN unresponsiveness in LNCaP cells due to the lack of JAK1 gene expression[J]. Cancer Res, 2005, 65(8):3447-3453. DOI:10.1158/0008-5472.can-04-4316.
[34] Le DT, Uram JN, Wang H, et al. PD-1 blockade in tumors with mismatch-repair deficiency[J]. N Engl J Med, 2015, 372(26):2509-2520. DOI:10.1056/NEJMoa1500596.
[35] Le DT, Durham JN, Smith KN, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade[J]. Science, 2017, 357(6349):409-413. DOI:10.1126/science.aan6733.
[36] Nomi T, Sho M, Akahori T, et al. Clinical significance and therapeutic potential of the programmed death-1 ligand/programmed death-1 pathway in human pancreatic cancer[J]. Clin Cancer Res, 2007, 13(7):2151-2157. DOI:10.1158/1078-0432.ccr-06-2746.