Ryan D P
Gastrointestinal Cancer Center, Massachusetts General Hospital Cancer Center, Dana-Farber/Partners Cancer Care, Boston, Massachusetts, USA.
Oncology (Williston Park). 2000 Dec;14(12 Suppl 11):38-41.
The current standard of care for patients with stage T3 rectal cancer is adjuvant combined-modality treatment with radiation and fluorouracil (5-FU)-based chemotherapy. Although data from randomized phase III trials comparing preoperative and postoperative combined-modality therapy are lacking, preoperative therapy is an option in T3 disease and can be considered the standard of care for T4 disease. Given its effects in reducing systemic disease in stage IV rectal cancer and its potential for radiosensitization of target tumors, oxaliplatin (Eloxatin), a new cytotoxic agent from the diaminocyclohexane platinum family, is being evaluated in preoperative combined-modality regimens in a Cancer and Leukemia Group B (CALGB) phase I/II study (protocol 89901) in T4 disease and an Eastern Cooperative Group (ECOG) phase I study (E-1297) in locally advanced T3 or T4 disease.
目前，T3期直肠癌患者的标准治疗方案是采用放疗和基于氟尿嘧啶（5-FU）的化疗进行辅助综合治疗。尽管缺乏比较术前和术后综合治疗的随机III期试验数据，但术前治疗是T3期疾病的一种选择，并且可被视为T4期疾病的标准治疗方案。奥沙利铂（乐沙定）是一种来自二氨基环己烷铂家族的新型细胞毒性药物，鉴于其在降低IV期直肠癌全身疾病方面的作用及其对靶肿瘤的放射增敏潜力，正在癌症和白血病B组（CALGB）针对T4期疾病的I/II期研究（方案89901）以及东部肿瘤协作组（ECOG）针对局部晚期T3或T4期疾病的I期研究（E-1297）的术前综合治疗方案中进行评估。
