EpicentRx, San Diego, CA.
Department of Medical Oncology, UC San Diego School of Medicine, San Diego, CA.
Semin Oncol. 2020 Feb;47(1):85-92. doi: 10.1053/j.seminoncol.2020.02.001. Epub 2020 Feb 21.
From a series of clinical trials in the last several decades, current treatment paradigms for locally advanced rectal cancer include: (1) preoperative long-course radiotherapy (RT) combined with radiosensitizing chemotherapy; (2) preoperative short-course RT alone followed by adjuvant postoperative chemotherapy; and (3) total neoadjuvant therapy with induction chemotherapy followed by chemoradiotherapy. Other strategies under active investigation in both institutional and cooperative trials include neoadjuvant chemotherapy alone without RT in select patients, total neoadjuvant therapy, watchful waiting after a clinical complete response as an alternative to surgical resection, and the use of different chemotherapeutic and targeted agents. The focus of this review is on established and novel therapeutic strategies for locally advanced rectal cancer.
从过去几十年的一系列临床试验来看，局部晚期直肠癌的当前治疗模式包括：（1）术前长程放疗（RT）联合放射增敏化疗；（2）术前短程 RT 单独治疗，然后进行辅助术后化疗；（3）新辅助治疗，先进行诱导化疗，然后进行放化疗。其他在机构和合作试验中积极研究的策略包括选择性患者的单纯新辅助化疗而不进行 RT、完全新辅助治疗、在临床完全缓解后作为手术切除的替代方案进行观察等待，以及使用不同的化疗药物和靶向药物。本综述的重点是局部晚期直肠癌的既定和新型治疗策略。
