从ESMO指南更新分析胰腺癌诊疗进展与发展趋势OA北大核心CSTPCD

Pancreatic cancer has a generally poor prognosis,with an increasing incidence worldwide,posing a significant threat to global public health.In September 2023,the European Society for Medical Oncology(ESMO)updated its guidelines on the diagnosis and treatment of pancreatic cancer.This update summarizes a decade of progress in the field,providing new evidence-based recommendations with strong guiding significance for the diagnosis and treatment of pancreatic cancer both domestically and internationally.According to the guidelines,research in pancreatic cancer focuses on four main areas:precision medicine,induction and conversion therapy,pancreatic cancer in the elderly,and the standardization of diagnostic and treatment procedures.Precision medicine encompasses precise diagnosis and targeted treatment.Precise diagnosis involves the molecular subtyping and genetic markers of pancreatic cancer,aiding in predicting the biological behavior,treatment response,and prognosis of pancreatic cancer.Targeted treatment involves drugs specifically designed for certain molecular markers,which have shown promising results in clinical trials but require further exploration for optimal combinations with chemotherapy,radiotherapy,or immunotherapy.Induction and conversion therapy are primarily applicable to borderline resectable pancreatic cancer(BRPC)and locally advanced pancreatic cancer(LAPC)patients.The goal of induction therapy is to increase the resection rate and quality of surgery,while conversion therapy aims to transform unresectable tumors into resectable ones.BRPC patients are recommended to undergo induction therapy with FOLFIRINOX or GN regimens,while LAPC patients are prioritized for conversion therapy with FOLFIRINOX or GN regimens.The choice of treatment duration and timing of surgery for induction and conversion therapy should be individualized based on patient characteristics and tumor biology,rather than solely on technical and local anatomical features.Elderly pancreatic cancer patients face unique challenges,and their treatment strategy should be based on comprehensive preoperative assessments,rather than age alone being a contraindication for surgery or chemotherapy.Standardization of diagnostic and treatment procedures is a key factor in improving the prognosis of pancreatic cancer patients.The treatment strategy for pancreatic cancer patients should be collaboratively developed by a specialized multidisciplinary team(MDT),and the assessability of resectability should be determined by the MDT considering factors such as imaging data,CA19-9 levels,physical condition scores,etc.Imaging reports for pancreatic cancer should use structured templates to enhance accuracy and consistency.