title: [Medical-oncological aspects in the treatment of pancreatic cancer].
abstract: Pancreatic cancer is a highly malignant disease and despite progress in systemic therapy survival is still short. For patients with R0/R1 resected disease, adjuvant chemotherapy with gemcitabine has been established as the standard treatment. More controversy exists with regard to optimal treatment of locally advanced non-metastatic pancreatic cancer. However, there is evidence to suggest that patients who respond to an initial phase of chemotherapy may be those who benefit most from sequential chemoradiotherapy. Specifically, in the treatment of advanced and metastatic disease chemotherapy or radiotherapy cannot stand alone but must be accompanied by multidisciplinary treatment approaches involving pain management, weight control, psychooncological care and palliative care. Monotherapy with gemcitabine and the combined use of gemcitabine with erlotinib are established standards for treatment of metastatic pancreatic cancer. Patients in a good general condition but where the gemcitabine-based therapy failed should be offered second-line treatment.
authors.affiliation: Medizinische Klinik und Poliklinik III, Klinikum Grosshadern, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland. Volker.Heinemann@med.uni-muenchen.de
authors.forename: V
authors.initials: V
authors.lastname: Heinemann
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D010166:Palliative Care; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011379:Prognosis; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic; D011799:Quinazolines; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069347:Erlotinib Hydrochloride; D000093542:Gemcitabine