胰腺癌术前放疗的概念1975年首先由Tepper等提出。理论上其优点主要为术前血运好,肿瘤细胞对放疗敏感;放疗后肿瘤与正常组织的界限变得清晰,增加切除率;由于减少了肠的受量而使患者易于耐受;较少出现空肠吻合口瘘。1972～1982年10例行Whipple术前放疗4000～5000cGy者,有3例生存5年以上,但余7例未有存活18个月以上者。Ishikawa最近报导了23例接受术前放疗者,其切除率和局部复发率均优于单纯手术者,但3年和5年生存率无差别。 许多试验组在术前放疗的同时加用化疗以提高疗效。其理论依据为实验室和临床均证明化疗可以增加放疗的敏感性。但目前尚无试验显示术前放化疗的优 The concept of preoperative radiotherapy for pancreatic cancer was first proposed by Tepper et al. in 1975. Theoretically, its advantages are mainly good preoperative blood supply, and the tumor cells are sensitive to radiotherapy; the boundaries between tumors and normal tissues become clear after radiotherapy, increasing the resection rate; patients are easily tolerated due to reduced intestinal absorption; Jejunal anastomotic leakage occurred. From 1972 to 1982, 10 patients who underwent Whipple preoperative radiotherapy from 4000 to 5000 cGy, 3 patients survived for more than 5 years, but the remaining 7 patients did not survive for more than 18 months. Ishikawa recently reported 23 patients who received preoperative radiotherapy. The resection rate and local recurrence rate were better than those of surgery alone, but there was no difference in the 3-year and 5-year survival rates. Many trial groups add chemotherapy before surgery to increase the efficacy. The theoretical basis for both laboratory and clinical evidence is that chemotherapy can increase the sensitivity of radiotherapy. However, no trials have shown excellent preoperative radiotherapy and chemotherapy