Goodman K A
University of Colorado Cancer Center, Professor, Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032 MS F706, Aurora, CO 80045, USA.
Cancer Radiother. 2018 Sep;22(5):459-465. doi: 10.1016/j.canrad.2018.01.004. Epub 2018 May 26.
While outcomes for patients with locally advanced disease have improved considerably with combined modality therapy, there is now an emphasis on developing risk-adapted treatment strategies. Moreover, the primary cause of death from locally advanced rectal cancer is related to distant progression, which now exceeds the rate of local failure. Thus, the necessity to optimally address micrometastatic disease has led to increasing interest in delivering chemotherapy in the neoadjuvant setting rather than in the postoperative setting. This review critically appraises the emerging literature on the options for sequencing of therapy, focusing on the total neoadjuvant therapy paradigm as well as emerging options for omitting components of multimodality therapy.
虽然局部晚期疾病患者通过综合治疗的疗效有了显著改善，但目前重点是制定风险适应性治疗策略。此外，局部晚期直肠癌的主要死亡原因与远处转移有关，目前远处转移的发生率已超过局部复发率。因此，优化处理微转移疾病的必要性使得人们对在新辅助治疗阶段而非术后阶段进行化疗的兴趣日益增加。本综述批判性地评估了关于治疗顺序选择的新出现的文献，重点关注新辅助治疗整体模式以及省略多模式治疗某些组成部分的新出现的选择。
