Department of Surgery, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, Latvia.
Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV-1002 Riga, Latvia.
Medicina (Kaunas). 2021 Sep 30;57(10):1044. doi: 10.3390/medicina57101044.
The response to neoadjuvant chemoradiation therapy is an important prognostic factor for locally advanced rectal cancer. Although the majority of the patients after neoadjuvant therapy are referred to following surgery, the clinical data show that complete clinical or pathological response is found in a significant proportion of the patients. Diagnostic accuracy of confirming the complete response has a crucial role in further management of a rectal cancer patient. As the rate of clinical complete response, unfortunately, is not always consistent with pathological complete response, accurate diagnostic parameters and predictive markers of tumor response may help to guide more personalized treatment strategies and identify potential candidates for nonoperative management more safely. The management of complete response demands interdisciplinary collaboration including oncologists, radiotherapists, radiologists, pathologists, endoscopists and surgeons, because the absence of a multidisciplinary approach may compromise the oncological outcome. Prediction and improvement of rectal cancer response to neoadjuvant therapy is still an active and challenging field of further research. This literature review is summarizing the main, currently known clinical information about the complete response that could be useful in case if encountering such condition in rectal cancer patients after neoadjuvant chemoradiation therapy, using as a source PubMed publications from 2010-2021 matching the search terms "rectal cancer", "neoadjuvant therapy" and "response".
新辅助放化疗的反应是局部晚期直肠癌的一个重要预后因素。虽然大多数接受新辅助治疗的患者在手术后会被转诊,但临床数据显示,相当一部分患者存在完全临床或病理缓解。明确完全缓解的诊断准确性在直肠癌患者的进一步管理中起着至关重要的作用。由于临床完全缓解的比例并不总是与病理完全缓解一致,因此肿瘤反应的准确诊断参数和预测标志物可能有助于指导更个性化的治疗策略,并更安全地识别潜在的非手术管理候选者。完全缓解的管理需要肿瘤学家、放射治疗师、放射科医生、病理学家、内镜医生和外科医生的跨学科协作,因为缺乏多学科方法可能会影响肿瘤学结果。预测和改善直肠癌对新辅助治疗的反应仍然是一个积极而具有挑战性的研究领域。这篇文献综述总结了目前关于新辅助放化疗后直肠癌完全缓解的主要临床信息,这些信息可能对遇到此类情况的直肠癌患者有用,使用的来源是 2010 年至 2021 年期间在 PubMed 上发表的与搜索词“直肠癌”、“新辅助治疗”和“反应”匹配的出版物。