Abstract: Comprehensive treatment of pancreatic cancer——from theoretical basis to clinical practice        LIU Liang, WANG Wen-quan, LOU Wen-hui. Department of Pancreatic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032,China
Corresponding author: LOU Wen-hui，E-mail：lou.wenhui@zs-hospital.sh.cn
Abstract    Pancreatic cancer has dismal prognosis. Comprehensive treatment is regarded as a hot topic at present. Sequential application of existing treatments is expected to improve the therapeutic efficacy through the "multiple hits" effect. Nevertheless, there is a solid theoretical basis for the comprehensive treatment of pancreatic cancer. Both the "evolutionary theory of cancer" and the "big bang model" provide theoretical support for the high heterogeneity and the systematic characteristics of pancreatic cancer, and only combination therapy can solve this problem at multiple levels and from multiple angles. However, there is no guideline yet to be followed for the implementation of comprehensive treatment of pancreatic cancer. Comprehensive treatment should be carried out in a planned and phased manner according to the guidance of scientific evidence and the patient condition, so as to achieve the purpose of comprehensive treatment, maximize the curative effect, and minimize toxic and side effects.

Key words: pancreatic cancer, comprehensive treatment, clinical practice, theoretical basis, principle

摘要： 胰腺癌预后极差，综合治疗成为目前研究热点。有序联合现有多种治疗手段有望通过“群殴”效应提高胰腺疗效。尽管如此，无论“癌症进化论”或是“大爆炸”理论，均为胰腺癌高度异质性和其系统性疾病的特征提供理论支持，也只有联合治疗策略才能在多层次和多角度上解决这一难题。然而，开展胰腺癌综合治疗尚“无章可循”，只有在科学证据指导下根据不同病人的具体情况，有计划、分阶段地实施个性化策略，才能达到综合治疗的目的，最大限度提高疗效，最大程度减少毒副反应。

关键词: 胰腺癌, 综合治疗, 临床实践, 理论基础, 原则