Department of Radiation Oncology, Penn State College of Medicine, Hershey, PA, USA.
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Cancer Control. 2020 Jan-Dec;27(1):1073274820969449. doi: 10.1177/1073274820969449.
Colorectal cancer is the third most common cancer in men and the second most common in women worldwide, and the incidence is increasing among younger patients. 30% of these malignancies arise in the rectum. Patients with rectal cancer have historically been managed with preoperative radiation, followed by radical surgery, and adjuvant chemotherapy, with permanent colostomies in up to 20% of patients. Beginning in the early 2000s, non-operative management (NOM) of rectal cancer emerged as a viable alternative to radical surgery in select patients. Efforts have been ongoing to optimize neoadjuvant therapy for rectal cancer, thereby increasing the number of patients potentially eligible to forgo radical surgery. Magnetic resonance guided radiotherapy (MRgRT) has recently emerged as a treatment modality capable of intensifying preoperative radiation therapy for rectal cancer patients. This technology may also predict which patients will achieve a complete response to preoperative therapy, thereby allowing for more appropriate selection of patients for NOM. The present work seeks to illustrate the potential role MRgRT could play in personalizing rectal cancer treatment thus expanding the role of NOM in rectal cancer.
结直肠癌是全世界男性中第三常见的癌症，也是女性中第二常见的癌症，其发病率在年轻患者中呈上升趋势。30%的这些恶性肿瘤发生在直肠。历史上，直肠癌症患者采用术前放疗、根治性手术和辅助化疗进行治疗，多达 20%的患者需要永久性结肠造口术。从 21 世纪初开始，非手术治疗（NOM）作为一种可行的替代根治性手术的方法，在特定患者中出现。人们一直在努力优化直肠癌的新辅助治疗，从而增加更多适合避免根治性手术的患者数量。磁共振引导放疗（MRgRT）最近作为一种治疗方式出现，能够增强直肠癌患者的术前放疗。这项技术还可以预测哪些患者将对术前治疗产生完全反应，从而能够更准确地选择适合 NOM 的患者。本研究旨在说明 MRgRT 在直肠癌个体化治疗中的潜在作用，从而扩大 NOM 在直肠癌治疗中的作用。
