中国胰腺癌综合诊治指南(2020版)  

Comprehensive guidelines for the diagnosis and treatment of pancreatic cancer(2020 version)

作　　者：中国抗癌协会胰腺癌专业委员会 赵玉沛[2] 虞先濬 刘亮[4] 王文权[4] 高鹤丽[4] Pancreatic Cancer Committee of Chinese Anti‑cancer Association;Zhao Yupei;Yu Xianjun

机构地区：[1]不详 [2]中国医学科学院,北京协和医学院,北京协和医院外科,100730 [3]复旦大学附属肿瘤医院胰腺外科/胰腺肿瘤综合治疗部,上海200032 [4]复旦大学附属肿瘤医院

出　　处：《中华外科杂志》2021年第2期81-100,共20页Chinese Journal of Surgery

摘　　要：近年来,胰腺癌的发病率呈上升趋势,其死亡率居恶性肿瘤的第3位。过去十年,胰腺癌的诊治取得了长足进步,然而国内不同地区水平参差不齐,其诊治现状依然严峻。2018年,中国抗癌协会胰腺癌专业委员会制定了《中国胰腺癌综合诊治指南(2018版)》,以期规范和提高中国胰腺癌诊治水平。2020年,专委会结合过去两年的发展现状制定了《中国胰腺癌综合诊治指南(2020版)》。其更新要点主要体现在以下方面:靶向和免疫治疗取得突破,遗传筛查及基因检测首次全面融入胰腺癌的综合诊治。第8版AJCC-TNM胰腺癌分期系统的实用性和准确性在国内多个中心获得验证,并用于临床实践。术前新辅助治疗成为交界可切除和局部进展期胰腺癌的标准治疗方式,并逐渐应用于可切除胰腺癌,新辅助治疗后手术探查尤为重要。以化疗为基础的系统治疗模式(包括靶向治疗和免疫治疗)进入临床研究,并在晚期胰腺癌中证实了维持治疗模式的临床获益性。多学科、多区域协作诊疗模式在国内广泛普及,并贯穿诊疗全程。国内临床试验的开展和多中心跨区域合作为胰腺癌新药研发和方案优化提供了适合国人的高级别循证医学证据。在新的理念和临床证据支持下,该版指南有望为我国胰腺癌的综合诊治工作提供指导。The incidence of pancreatic cancer has increased in recent years,and the mortality has ranked the third among malignant tumors.Advances have been made in the diagnosis and treatment of pancreatic cancer in the past decade,however,the current situation is still severe due to the uneven medical level in different regions of China.In 2018,Pancreatic Cancer Committee of Chinese Anti-cancer Association formulated the"Chinese comprehensive guidelines for the diagnosis and treatment of pancreatic cancer(2018 version)",with the view for standardizing and improving the level of diagnosis and treatment of pancreatic cancer in China.In 2020,the committee worked out the latest version of"Chinese comprehensive guidelines for the diagnosis and treatment of pancreatic cancer(2020 version)",based on the development in the past two years.These updates were mainly reflected in the following aspects:breakthroughs in targeted therapy and immunotherapy,and genetic screening and genetic sequencing has been firstly applied in the comprehensive diagnosis and treatment of pancreatic cancer.The practicability and accuracy of the 8th edition of AJCC-TNM staging system for pancreatic cancer has been validated in multi-center of China and has been used in clinical practice.Preoperative neoadjuvant therapy has become the standard treatment for borderline resectable and locally advanced pancreatic cancer,and it is gradually applied to the resectable pancreatic cancer.The surgical exploration after neoadjuvant therapy is particularly important.Chemotherapy-based systemic treatment modality,including targeted therapy and immunotherapy,has been carried out in clinical trial setting,and the benefits of maintenance therapy have been confirmed in advanced pancreatic cancer.The multi-disciplinary and multi-regional collaborative diagnosis and treatment pattern is widely popularized in China and runs through the entire diagnosis and treatment process.The development of domestic clinical trials and multi-center,cross-regional cooperation provides high-

关 键 词：胰腺肿瘤 综合疗法 临床诊断标准 规范化 指南 

分 类 号：R735.9[医药卫生—肿瘤]