Tseng Michelle, Soon Yu Yang, Vellayappan Balamurugan, Ho Francis, Tey Jeremy
Department of Radiation Oncology, National University Cancer Institute, Singapore (NCIS), National University Health Systems (NUHS), Singapore, Singapore.
J Gastrointest Oncol. 2019 Dec;10(6):1238-1250. doi: 10.21037/jgo.2018.12.04.
Radiotherapy (RT) has remained an important pillar in the multi-modality management of rectal cancer. Adjuvant RT with concurrent chemotherapy (chemo-RT) was once the standard of care for locally advanced rectal cancer, but with time, that has now changed and neoadjuvant chemo-RT followed by total mesorectal excision (TME) surgery is the new standard. Alternatively, neoadjuvant RT alone remains an option and clinicians are tasked to choose between the two. In an era of personalised oncological management, it is unsurprising that the treatment for rectal cancer is following suit and upcoming trials are studying ways to improve outcomes and minimise toxicity for patients while tailoring treatments specific to each patient's tumour. We review the evolution of the role of RT in rectal cancer and look forward to what the future holds.
放射治疗（RT）一直是直肠癌多模式治疗的重要支柱。辅助放疗联合同步化疗（放化疗）曾是局部晚期直肠癌的标准治疗方案，但随着时间的推移，情况已发生变化，新辅助放化疗后行全直肠系膜切除术（TME）已成为新标准。另外，单纯新辅助放疗仍是一种选择，临床医生需在这两种方案之间做出抉择。在肿瘤个性化治疗的时代，直肠癌治疗紧跟潮流也就不足为奇了，即将开展的试验正在研究如何改善患者预后并将毒性降至最低，同时针对每位患者的肿瘤制定个性化治疗方案。我们回顾了放疗在直肠癌治疗中作用的演变，并展望未来的发展。
