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新辅助治疗常被应用于进展期胰腺癌病人以达到肿瘤降期的目的,从而提高手术的可切除性。而对于手术时机的选择,一直没有定论,存在争议。对于新辅助化疗后转化成功,肿瘤缩小,达到降期的胰腺癌病例,建议直接行手术切除。结合既往前瞻性和回顾性研究报道以及笔者中心的新辅助治疗数据,建议新辅助治疗的疗程为4~6个周期,手术时机建议选择在新辅助治疗后4~8周。对于手术方式的选择,可以考虑先行腹腔镜探查,确认有无转移和初步鉴定手术的可切除性后,再行进一步的手术切除治疗。
Neoadjuvant therapy is often used in patients with advanced pancreatic cancer in order to achieve the purpose of tumor down, so as to improve the resectability of surgery. The timing of the operation of choice, there has been no conclusion, there is controversy. For neoadjuvant chemotherapy after the successful conversion, tumor shrinkage, down to reach the case of pancreatic cancer, it is recommended direct surgical resection. Combined with previous prospective and retrospective study reports and neo-adjuvant treatment data in the author’s center, it is recommended that neoadjuvant treatment course be 4 to 6 cycles, and the timing of surgery is suggested to be 4-8 weeks after neoadjuvant treatment. For the choice of surgical approach, consider the first laparoscopy to confirm the presence or absence of metastasis and the initial identification of resectability of the surgery, then further surgical resection.