Michel P, Di Fiore F
Unité d'oncologie urodigestive, pôle viscéral, hôpital Charles-Nicolle, CHU de Rouen, Rouen cedex, France.
Cancer Radiother. 2011 Oct;15(6-7):436-9. doi: 10.1016/j.canrad.2011.06.002. Epub 2011 Aug 31.
Chemotherapy does not increase the survival time of patients treated for rectal cancer. Chemotherapy given concomitantly to radiotherapy and combined before or after radiation significantly reduces the risk of local recurrence. The sterilization of the tumour (complete pathological response) by chemotherapy is a favourable prognostic factor. New trials on optimisation of pathological complete response rates are based on using drugs effective on metastatic colorectal cancer, given prior to chemoradiotherapy and followed by a resection at least 8 weeks after the end of the radiotherapy. The level of evidence for postoperative chemotherapy is low due to lack of specific study. The indication of postoperative chemotherapy depends on the disease extent after preoperative treatment.
化疗不会延长直肠癌患者的生存时间。同步进行化疗与放疗以及在放疗前后联合化疗可显著降低局部复发风险。化疗使肿瘤发生无菌性坏死（完全病理缓解）是一个有利的预后因素。关于优化病理完全缓解率的新试验基于在放化疗前使用对转移性结直肠癌有效的药物，并在放疗结束后至少8周进行切除。由于缺乏具体研究，术后化疗的证据水平较低。术后化疗的指征取决于术前治疗后的疾病范围。
