直肠癌的新辅助治疗

Neoadjuvant Therapy for the Rectal Cancer

局部晚期直肠癌的治疗已经形成放疗、化疗联合手术切除的多学科综合治疗的模式。NCCN指南推荐的局部晚期直肠癌综合治疗的最佳顺序是新辅助短程放疗或新辅助同步放化疗后接受全直肠系膜切除手术,随后4个月的辅助化疗。新辅助治疗可以使肿瘤降期、降级,达到提高根治性切除率、减少局部复发和增加保肛率的目的。但是随着晚期治疗中更高疗效药物的出现以及对生活质量的重视,个体化治疗成为未来研究的方向。

The treatment of the locally advanced rectal cancer had entered the multimodel treatment combined with radiotherapy, chemotherapy and surgery. NCCN guidelines recommended the best sequence is neoadjuvant short-course radiotherapy or concurrent chemoradiotherapy, then total mesorectal excision, thereafter four months of adjuvant chemotherapy. Neoadjuvant therapy can make tumor down-stage and degradation, improve the radical resection, reduce the local recurrence and increase the sphincter preservation. But with the advent of more effective drugs and the emphasize on the quality of life, the individualized therapy for rectal cancer has become the keypoint in the future research.