Adjuvant and palliative therapy of pancreatic cancer

作者：Oettle H^*; Pelzer U; Stieler J; Riess H

来源：Onkologe, 2010, 16(6): 43-51.

DOI：10.1007/s00761-010-1851-5

• Pancreatic cancer
• Adjuvant therapy
• Gemcitabin
• 5-Fluorouracil
• Palliative therapy
• Second line

The only curative treatment of pancreatic cancer is complete resection (RO), however, at the time of diagnosis resection is only possible in a maximum of 20% of patients. Surgery-associated mortality is low in selected surgical centers, but the majority of patients suffer a recurrence even after complete resection and die of the disease. The mean survival time after resection lies between 11 and 23 months and the 5-year survival time of surgical patients between 10 and 25%. According to current inormation adjuvant chemotherapy is becoming increasingly more accepted. The good results with gemcitabin in two studies have shown that the data position for adjuvant therapy is stable.
In the United States radiochemotherapy with 5-fluorourcil is recommended as possible standard adjuvant therapy based on the results of a randomized study of the Gastrointestinal Tumor Study Group (GITSG) but radiochemotherapy is normally not employed in Europe. This discrepancy results from contradictions between published studies, which showed partly low case numbers or methodological shortcomings.
Therapy with gemcitabim has been the established standard therapy in the palliative situation since its introduction 10 years ago. The additional administration of the tyrosine kinase inhibitor erlotinib results in a clear advantage for survival in selected patients with a skin reaction. Patients in a good general physical condition can primarily be treated with a combined intensified therapy depending on the individual preferences because a survival advantage was shown here for the subgroups in the corresponding studies

• 出版日期2010-6