Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21287, USA.
Curr Oncol Rep. 2018 Jul 5;20(9):68. doi: 10.1007/s11912-018-0714-x.
For patients with locally advanced rectal cancer, neoadjuvant hypofractionated short-course radiation remains an underutilized regimen in the USA. We review the current clinical literature highlighting the relative merits of short-course radiation, along with modern neoadjuvant strategies that incorporate its use.
As compared to long-course chemoradiation with delayed surgery, short-course radiation with early surgery offers similar oncologic efficacy for locally advanced rectal cancer patients. Delaying surgery after short-course radiation decreases post-operative complications as compared to early surgery and improves tumor downstaging. Delaying surgery also offers the opportunity to administer neoadjuvant systemic therapy, which may help increase local-regional tumor response and potentially decrease distant relapse rates, the latter a persisting problem in rectal cancer treatment. Short-course radiation, either with immediate or with delayed surgery, represents an appealing treatment alternative to long-course chemoradiation for patients with locally advanced rectal cancer.
对于局部进展期直肠癌患者，新辅助短程低分割放疗在美国仍未得到广泛应用。我们综述了目前的临床文献，重点介绍了短程放疗的相对优势，以及将其应用于现代新辅助策略。
与长程放化疗联合延迟手术相比，短程放疗联合早期手术对局部进展期直肠癌患者具有相似的肿瘤学疗效。与早期手术相比，短程放疗后延迟手术可降低术后并发症，并改善肿瘤降期。延迟手术还提供了给予新辅助全身治疗的机会，这可能有助于增加局部区域肿瘤的反应，并可能降低远处复发率，后者是直肠癌治疗中仍然存在的问题。短程放疗，无论是立即手术还是延迟手术，对于局部进展期直肠癌患者来说，都是一种有吸引力的治疗选择，可替代长程放化疗。
