Royal Marsden Hospital, London & Surrey, United Kingdom.
Semin Radiat Oncol. 2011 Jul;21(3):196-202. doi: 10.1016/j.semradonc.2011.02.005.
Current management of early-stage rectal cancer comprises combinations of surgery, radiotherapy, and chemotherapy, with the presence or absence of several validated high-risk features determining which treatment modalities will be used and the order of administration. In high-risk individuals, most centers have adopted neoadjuvant combined chemotherapy and radiotherapy followed by surgery as the initial approach. However, long-term toxicity, limited survival gains, and high rates of distant failure have called this approach into question, with early data suggesting that neoadjuvant chemotherapy alone may be feasible in selected patient groups. This review discusses the current data and feasibility of managing early stage rectal cancer with neoadjuvant chemotherapy before surgical resection.
目前，早期直肠癌的治疗方法包括手术、放疗和化疗的综合应用，根据高危特征的存在与否，决定使用哪些治疗方式以及治疗的先后顺序。在高危人群中，大多数中心采用新辅助联合化疗和放疗，然后再进行手术作为初始治疗方法。然而，长期毒性、生存获益有限以及远处转移失败率高，使得这种治疗方法受到质疑，早期数据表明，新辅助化疗单独应用于某些特定患者群体可能是可行的。本文讨论了在手术切除前使用新辅助化疗治疗早期直肠癌的现有数据和可行性。
