Bosset Jean-François, Nguyen France, Bosset Mathieu, Servagi-Vernat Stéphanie, Schipman Benjamin
Department of Radiation-Oncology, Besançon University Hospital, Boulevard Fleming, F-25030 Besançon Cedex, France.
Curr Oncol Rep. 2008 May;10(3):220-4. doi: 10.1007/s11912-008-0034-7.
Randomized clinical trials have recently established preoperative chemoradiotherapy as the new standard treatment for patients with localized cT3-T4 or N+ rectal cancer. Although its inclusion in the modern multidisciplinary management of patients with rectal cancer makes total eradication of pelvic failure a near reality, it does not yet translate into improved survival. As a result, clinical research should be primarily directed against the micrometastatic process, focusing on integrating innovative strategies, such as upfront chemotherapy before chemoradiation, in subgroups of patients recognized to be at high risk.
随机临床试验最近已将术前放化疗确立为局部cT3-T4期或N+期直肠癌患者的新标准治疗方法。尽管将其纳入直肠癌患者的现代多学科管理使盆腔失败的完全根除几乎成为现实，但这尚未转化为生存率的提高。因此，临床研究应主要针对微转移过程，重点是在被认为高危的患者亚组中整合创新策略，如在放化疗前进行前期化疗。
