直肠癌术前放疗的研究进展

Research Progress of Preoperative Radiotherapy for Rectal Cancer

目的总结近年来直肠癌术前放化疗的研究进展。方法复习近年来国内、外有关直肠癌术前放化疗的相关文献报道。结果术前放疗的远期局部复发率较术后放化疗明显降低,无瘤生存期明显延长;在Ⅲ期直肠癌患者,术前短程放疗比术前常规放疗具有更高的局部复发率,而在Ⅱ期直肠癌患者二者的局部复发率差异无统计学意义;p53、CEA、Cox-2、EGFR、VEGF等生物学因子是判断直肠癌术前放疗效果的敏感指标。结论直肠癌的术前放疗方案倾向于选择术前常规放疗,多种敏感因子的广泛研究及基因表达谱、基因芯片的发展为直肠癌术前放疗个体化方案的制定提供了更多的筛选指标。

Objective To summarize the current advancement of preoperative radiotherapy for rectal cancer.Methods Relevant literatures about current advancement of preoperative radiotherapy for rectal cancer published domesticly and abroad recently were collected and reviewed.Results The lower local recurrence rate and longer disease-free survival time were observed in preoperative radiotherapy,compared with postoperative radiotherapy for rectal cancer.The recurrence rate was higher in short-course radiotherapy,compared with conventionally radiotherapy for stageⅢrectal cancer,but there was no significant difference for stageⅡrectal cancer.The biology molecular such as p53,CEA,Cox-2,EGFR,and VEGF had shown to be radiosensitive.Conclusion sThe proposal of preoperative radiotherapy for rectal cancer,could be prone to conventionally radiotherapy.There are more screening targets for preoperative radiotherapy in extensive exploration of diverse radiosensitivity.Biology molecular,developed gene expression profiling,and gene chips for rectal cancer may contribute to the individualization treatment.