三药化疗在局部进展期直肠癌新辅助治疗中的应用

Application of three-drug chemotherapy in neoadjuvant therapy for locally advanced rectal cancer

目前局部进展期直肠癌(locally advanced rectal cancer,LARC)的标准治疗模式为新辅助放化疗联合直肠全系膜切除和辅助化疗,患者的生存预后显著改善,但远处转移率仍较高。既往常应用于新辅助治疗中的化疗方案为FOLFOX(奥沙利铂+氟尿嘧啶/亚叶酸钙)或FOLFIRI(伊立替康+氟尿嘧啶/亚叶酸钙)双药方案,而FOLFOXIRI(氟尿嘧啶/亚叶酸钙+奥沙利铂+伊立替康)三药方案强度更高,本文就三药化疗在LARC新辅助治疗中的应用展开综述,以期为临床诊疗提供参考。

The standard treatment of locally advanced rectal cancer(LARC)is the mode of neoadjuvant chemoradiotherapy(CRT)followed by total mesorectal excision(TME)plus adjuvant chemotherapy(ACT).Neoadjuvant therapy significantly improves prognosis.However,the rate of distant metastasis is still kept high.The usual neoadjuvant chemotherapy is FOLFOX or FOLFIRI two-drug regimens,while FOLFOXIRI three-drug regimen remains stronger.This article has summarized the application of three-drug chemotherapy in neoadjuvant therapy for LARC,hoping to provide reference for clinical diagnosis and treatment.