Rau B, Wust P, Riess H, Schlag P M
Klinik für Chirugie und Chirurgische Onkologie, Robert-Rössle-Klinik, Charité, Humboldt Universität zu Berlin.
Zentralbl Chir. 2000;125(4):356-64.
In locally advanced rectal cancer RO-resectability is limited and outcome is combined with a relatively high rate of local recurrences. This paper focuses on experiences with preoperative (neo-)adjuvant therapy and the potential improvement of treatment results.
Different therapy regimen were demonstrated under consideration of therapeutic induced side effects, treatment response (downstaging) in relation to resectability, recurrence free and overall survival.
The rate of treatment induced toxicity of preoperative radio-(chemo-)therapy in locally advanced rectal cancer is acceptable with regard to the obtained treatment results. Through the pretreatment it was possible to gain a downstaging by nearly 60%. The frequency of local recurrence is significantly reduced by preoperative radiotherapy, and combined radiochemotherapy possibly increases the disease free survival. In what extent the results of treatment could be improved through hyperthermia and/or consecutive postoperative chemotherapy, is proved at present.
Preoperative radio-(chemo-)therapy should be increasingly introduced into the standard treatment regimen of locally advanced rectal cancer and has to be optimised within the scope of further studies.
在局部晚期直肠癌中，RO切除的可能性有限，且预后伴随着相对较高的局部复发率。本文聚焦于术前（新）辅助治疗的经验以及治疗效果的潜在改善。
考虑到治疗引起的副作用、与可切除性相关的治疗反应（降期）、无复发生存率和总生存率，展示了不同的治疗方案。
就所获得的治疗效果而言，局部晚期直肠癌术前放（化）疗的治疗引起的毒性发生率是可接受的。通过预处理，有可能实现近60%的降期。术前放疗显著降低了局部复发的频率，联合放化疗可能会提高无病生存率。目前尚不清楚热疗和/或术后序贯化疗能在多大程度上改善治疗效果。
术前放（化）疗应越来越多地纳入局部晚期直肠癌的标准治疗方案，并必须在进一步研究的范围内进行优化。
