Li Yi, Wang Ji, Ma Xiaowei, Tan Li, Yan Yanli, Xue Chaofan, Hui Beina, Liu Rui, Ma Hailin, Ren Juan
2. Department of Chemotherapy, Oncology Department, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
3. Intensive Care Unit, China Mei Tan General Hospital, ChaoYang, Beijing 100028, P.R. China.
Int J Biol Sci. 2016 Jul 17;12(8):1022-31. doi: 10.7150/ijbs.15438. eCollection 2016.
Neoadjuvant chemoradiotherapy has become the standard treatment for locally advanced rectal cancer. Neoadjuvant chemoradiotherapy not only can reduce tumor size and recurrence, but also increase the tumor resection rate and anus retention rate with very slight side effect. Comparing with preoperative chemotherapy, preoperative chemoradiotherapy can further reduce the local recurrence rate and downstage. Middle and low rectal cancers can benefit more from neoadjuvant chemradiotherapy than high rectal cancer. It needs to refine the selection of appropriate patients and irradiation modes for neoadjuvant chemoradiotherapy. Different therapeutic reactions to neoadjuvant chemoradiotherapy affect the type of surgical techniques, hence calling for the need of much attention. Furthermore, many problems such as accurate staging before surgery, selection of suitable neoadjuvant chemoradiotherapy method, and sensitivity prediction to preoperative radiotherapy need to be well settled.
新辅助放化疗已成为局部晚期直肠癌的标准治疗方法。新辅助放化疗不仅可以缩小肿瘤大小、降低复发率,还能提高肿瘤切除率和保肛率,且副作用非常轻微。与术前化疗相比,术前放化疗可进一步降低局部复发率并使肿瘤降期。中低位直肠癌比高位直肠癌从新辅助放化疗中获益更多。需要优化新辅助放化疗合适患者的选择及照射方式。对新辅助放化疗的不同治疗反应会影响手术技术类型,因此需要予以高度关注。此外,术前准确分期、合适新辅助放化疗方法的选择以及术前放疗敏感性预测等诸多问题都需要妥善解决。