Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 549

Surgery alone offers the hope of cure and, even if performed, offers a five‐year survival rate of only 20%. Adjuvant therapy with a fluorouracil‐based chemotherapy protocol (e.g. FOLFIRINOX) is the first‐line systemic therapy. In patients with unresectable disease, chemoradiation can be used. Gemcitabine is the standard of care in locally advanced unresectable pancreatic adenocarcinoma, and the agent may also be used as part of a combined chemotherapy protocol.²⁴

Despite significant ongoing advances in efficacy and tolerability of treatment approaches, many patients with pancreatic adenocarcinoma, including those who could be curable, are not referred for multidisciplinary oncologic evaluation. In general, our recommendation is that even in the elderly or chronically ill patient who may decline treatment, a formal consultation with an oncology team is important to ensure that patients and families are aware of all treatment options, ranging from potentially curative to palliative.