Kawai Kazushige, Ishihara Soichiro, Nozawa Hiroaki, Hata Keisuke, Kiyomatsu Tomomichi, Tanaka Toshiaki, Nishikawa Takeshi, Otani Kensuke, Yasuda Koji, Murono Koji, Sasaki Kazuhito, Watanabe Toshiaki
Department of Surgical Oncology, The University of Tokyo.
J Anus Rectum Colon. 2018 May 25;1(2):39-44. doi: 10.23922/jarc.2017-005. eCollection 2017.
Preoperative chemoradiotherapy (CRT) has been actively used in Europe and the United States to treat advanced low rectal cancer, and provides excellent local control. In Japan, however, the standard treatment is lateral lymph node dissection, and to date CRT has not been actively used. In recent years, an increasing number of Japanese institutions have been using preoperative CRT to treat locally advanced rectal cancer. In this review, we describe the latest trends in CRT under five headings: short-course or long-course radiation, efforts to improve combined chemotherapy, the addition of preoperative adjuvant chemotherapy, the watch and wait strategy, and the significance of lateral lymph node dissection in patients receiving CRT.
术前放化疗（CRT）已在欧美积极用于治疗晚期低位直肠癌，并能提供良好的局部控制。然而，在日本，标准治疗方法是侧方淋巴结清扫，迄今为止尚未积极应用CRT。近年来，越来越多的日本机构开始使用术前CRT治疗局部晚期直肠癌。在本综述中，我们将在以下五个标题下描述CRT的最新趋势：短程或长程放疗、改进联合化疗的努力、术前辅助化疗的添加、观察等待策略以及CRT患者侧方淋巴结清扫的意义。
