2022年度结直肠癌治疗进展

New progress in colorectal cancer treatment in 2022

在全球范围内结直肠癌已经是最常见的癌症之一。近些年来,结直肠癌持续上升的发病率给社会经济带来了巨大压力。尽管治疗手段在不断地进步,但是结直肠癌的死亡率仍居高不下,这需要持续不断探索新的治疗模式。结直肠癌的治疗可分为围手术期治疗和转移性结直肠癌治疗。在围手术期治疗中,从传统开腹手术发展到腹腔镜辅助或机器人辅助手术,这种技术的进步改善了结直肠癌患者术后康复和生存预后。为进一步提高患者的整体生存预后,全程新辅助治疗的推广及免疫检查点抑制剂在微卫星不稳定型结直肠癌中的应用极大地提高了患者的长期生存率和器官保留率,是围手术期治疗的重要组成部分。在转移性结直肠癌治疗中,虽然化疗和靶向药物的进步使得生存率有所提高,但其整体疗效尚未达到预期效果,特别是相关基因突变导致的难治性转移性结直肠癌的治疗。因此,无论局部进展期结直肠癌还是转移性结直肠癌,均需更多的研究以探索和验证结直肠癌新的治疗模式,才能不断地提高结直肠癌的治疗效果。本文将回顾并介绍2022年度结直肠癌治疗进展。

Colorectal cancer(CRC)is one of the most common cancer types in worldwide.In recent years,there has been an alarming rise in CRC incidence with enormous social and economic consequences.Despite of therapeutic advances over recent years,the mortality rate of CRC remains high primarily because of tumor recurrence and metastasis.It is required to continuously improve and explore the therapeutic patterns.Therapy for CRC consist of perioperative treatment and treatment of metastatic colorectal cancer(mCRC).Since conventional open surgery has developed to laparoscopic-assisted and robotic-assisted surgery,it has enhanced postoperative recovery and survival for patients with CRC.To further build up the prognosis of CRC patients,the promotion of total neoadjuvant therapy and the application of immune checkpoint inhibitors for CRC patients with microsatellite instability high,a vital component of perioperative treatment,could largely improve long-term survival and organ preservation rate of CRC patients.In addition,although outcomes of patients with mCRC have been improved by advances in chemotherapy and targeted agents,but the therapeutic effects were not satisfactory.Thus,for the improvement of therapeutic effect of CRC,more researches need to be performed for investigating and validating new therapeutic strategies of locally advanced colorectal cancer and mCRC.This review presents the recent researches regarding the treatment of CRC.