Greenhalgh T A, Dearman C, Sharma R A
NIHR Oxford Biomedical Research Centre, CRUK-MRC Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK.
NIHR Oxford Biomedical Research Centre, CRUK-MRC Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK.
Clin Oncol (R Coll Radiol). 2016 Feb;28(2):116-139. doi: 10.1016/j.clon.2015.11.002. Epub 2015 Dec 21.
Neoadjuvant chemoradiotherapy with fluoropyrimidines is an established treatment in the management of locally advanced rectal cancer. There has been a great deal of research into improving patient outcomes by modifying this regimen by the addition of further radiosensitising agents. One of the difficulties in advancing new combination therapies has been lack of consensus on which surrogate measures best reflect clinically important outcomes. Here we review combinations of the cytotoxic, biological and other agents currently under scrutiny to improve clinical outcomes for patients with colorectal cancer. We also discuss advances in biomarkers that may ultimately result in an ability to tailor neoadjuvant chemoradiotherapy regimens to the somatic gene profile of individual patients.
氟嘧啶新辅助放化疗是局部晚期直肠癌治疗的既定方案。通过添加进一步的放射增敏剂来修改该方案以改善患者预后,这方面已经有大量研究。推进新联合疗法的困难之一在于,对于哪种替代指标最能反映临床重要结局缺乏共识。在此,我们综述目前正在研究的细胞毒性、生物制剂及其他药物的联合应用情况,以改善结直肠癌患者的临床结局。我们还讨论了生物标志物方面的进展,这些进展最终可能使我们有能力根据个体患者的体细胞基因谱来定制新辅助放化疗方案。