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第42卷第3期                           南京医科大学学报(自然科学版)
                  2022年3月                   Journal of Nanjing Medical University(Natural Sciences)     ·437 ·


               ·综 述·

                联合消融的综合疗法在进展期胰腺癌中的应用现状与进展



                张宸恺,张 彬,顾玉青,李亚男,钱祝银                *
                南京医科大学第二附属医院胰腺中心,江苏 南京                  210023




               [摘   要] 进展期胰腺癌预后极差,恶性程度高,生存时间极短,难以靠外科手段达到根治目的。单纯的放、化疗在进展期胰
                腺癌中效果有限,患者总体生存时间并不理想,因此探索进展期胰腺癌的消融治疗一直是近些年来的研究热点,其中包含了射
                频消融术(radio⁃frequency ablation,RFA)、冷冻消融术(cryoablation)、不可逆电穿孔(irreversible electroporation,IRE)、高强度聚
                焦超声治疗(high intensity focused ultrasound,HIFU)等诸多方式。不仅如此,消融联合放化疗以及免疫治疗等综合治疗方案,
                对进展期胰腺癌患者往往可以达到有效提高其生存期的目的。文章对进展期胰腺癌中以消融为主体的综合整体治疗现况及
                进展作一综述。
               [关键词] 消融技术;综合治疗;进展期胰腺癌
               [中图分类号] R735.9                   [文献标志码] A                       [文章编号] 1007⁃4368(2022)03⁃437⁃06
                doi:10.7655/NYDXBNS20220321


                Current status and progress of ablation ⁃ oriented combined treatment for advanced
                pancreatic cancer

                ZHANG Chenkai,ZHANG Bin,GU Yuqing,LI Yanan,QIAN Zhuyin   *
                Pancreas Center,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210023,China


               [Abstract] Advanced pancreatic cancer has a poor prognosis and a short survival,and usually can not be treated by surgery. The
                efficacy of radiotherapy and chemotherapy alone in advanced pancreatic cancer is limited,and the overall survival time of patients is
                poor. Therefore,the exploration of ablation therapy for advanced pancreatic cancer has been a research hot spot in recent years. These
                include radio⁃frequency ablation(RFA),cryoablation,irreversible electroporation(IRE),high intensity focused ultrasound(HIFU)and
                many other methods. Moreover,ablation combined with chemoradiotherapy and immunotherapy can form a comprehensive treatment
                strategy for patients with advanced pancreatic cancer,often achieve the purpose of effectively improving the survival of patients. This
                article reviews the current status of comprehensive treatment strategies for advanced pancreatic cancer after ablation therapy.
               [Key words] ablation technique;combined treatment;advanced pancreatic cancer
                                                                              [J Nanjing Med Univ,2022,42(03):437⁃442]




                    胰腺癌是一种恶性程度较高的消化系统肿瘤,                          腺癌)。调查统计显示,局部进展期及转移性胰腺
                                                                                             [3]
                具有起病隐匿、进展迅速的特点。2020年胰腺癌患                          癌患者中位生存期仅3~6个月 。针对进展期胰腺
                                                    [1]
                者中位生存期仅6个月,5年生存率仅8% ,在所有                          癌患者,最普遍的方案为化疗、放疗或两者结合,然
                胰腺癌患者中,仅20%的患者为可切除胰腺癌 ,剩                          而效果不理想。如何减轻患者痛苦、延长患者寿命
                                                         [2]
                余患者已经失去根治手术机会(不可切除胰腺癌包                            无疑是进展期胰腺癌最为关心的问题。对于进展期
                括 40%~50%的局部进展期胰腺癌和 50%转移性胰                       胰腺癌,国内外指南一致推荐需要多学科、多手段联
                                                                  合治疗,并开展相应技术的临床研究               [4⁃-5] 。

               [基金项目] 南京市卫生科技发展专项资金项目一般性课题                        1 胰腺癌常用的消融方法
               (YKK18188)
                ∗                                                     消融技术治疗实体肿瘤历史悠久,在进展期胰
                通信作者(Corresponding author),E⁃mail:qianzhusilver@163.com
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