Ⅱ～Ⅲ期可切除直肠癌的综合治疗

Combined modality therapy on resectable stage Ⅱ～Ⅲ rectal cancer

对于Ⅱ～Ⅲ期可手术切除直肠癌,单纯手术不再是唯一的治疗手段,综合治疗是其标准的治疗方法。术前放射治疗可以降低Ⅱ～Ⅲ期直肠癌的局部区域复发率,但是否可以显著提高长期生存率还无定论。Ⅱ～Ⅲ期直肠癌根治术后的同步放化疗+术后放射治疗是其标准的治疗手段,术后的同步放化疗不仅可以显著提高局部区域控制率,更可以显著提高长期生存率。另外,5-FU持续静脉滴注的同步化疗的疗效更优于静脉推注。在时间安排上,根治术后以同步放化疗后辅助化疗为宜。近年来,新药也开始应用于直肠癌同步放化疗的临床研究中,希望可以得到比5-FU为基础的同步放化疗更优的疗效。

For resectable stage Ⅱ～Ⅲ rectal cancer, combined modality therapy is the standard treatment. Preoperative radiation can reduce the local - regional recurrent rote, but it was doubtful to improve long - term survival rate. Postoperative concurrent chemoradiotherapy has been the standard of care for stage Ⅱ～Ⅲ rectal cancer as it can not only improve the local - regional control rate, but also significantly prolong the survival time. Furthermore, 5 - FU infusion is better than 5 - FU bolus for concurrent chemoradiation setting, and it＇s better for the patients if they receive concurrent chemoradiotherapy earlier than adjuvant chemotherapy. In recent several years, new drugs have been employed into concurrent ehemoradiation setting which are expected to achieve better effects.