Stępień Grzegorz J, Włodarczyk Jakub, Maryńczak Kasper, Prusisz Mateusz, Porc Mateusz, Włodarczyk Marcin, Waśniewska-Włodarczyk Anna, Dziki Łukasz
Department of General and Oncological Surgery, Medical University of Lodz, 92-213 Lodz, Poland.
Department of Otolaryngology, Polish Mother's Memorial Hospital Research Institute, 93-338 Lodz, Poland.
Cancers (Basel). 2024 Sep 27;16(19):3287. doi: 10.3390/cancers16193287.
Owing to the gradual aging of today's population, an increase in the prevalence of frailty syndrome has been noticed. This complex state of health, characterized by decreased resilience and tolerance with concurrent increased vulnerability to stressors and adverse health-related factors, has drawn researchers' attention in recent years. Rectal cancer, which constitutes ~30% of all colorectal cancers, is a disease noticeably related to the elderly. In its locally advanced form, it is conventionally treated with trimodal therapy-neoadjuvant chemoradiotherapy followed by total mesorectal excision and adjuvant chemotherapy. Despite its good clinical outcomes and improvement in rectal cancer local control, as evidenced by clinical trials, it remains unclear if all frail patients benefit from that approach since it may be associated with adverse side effects that cannot be handled by them. As old patients, and frail ones even more noticeably, are poorly represented in the clinical trials describing outcomes of the standard treatment, this article aims to review the current knowledge on the trimodal therapy of rectal cancer with an emphasis on novel approaches to rectal cancer that can be implemented for frail patients.
由于当今人口的逐渐老龄化，衰弱综合征的患病率有所上升。这种复杂的健康状态，其特征是恢复力和耐受性下降，同时对应激源和不良健康相关因素的易感性增加，近年来引起了研究人员的关注。直肠癌约占所有结直肠癌的30%，是一种与老年人明显相关的疾病。对于局部晚期直肠癌，传统上采用三联疗法——新辅助放化疗，随后进行全直肠系膜切除术和辅助化疗。尽管临床试验证明三联疗法具有良好的临床效果并改善了直肠癌的局部控制，但尚不清楚所有体弱患者是否都能从该方法中获益，因为它可能会带来一些他们无法承受的不良副作用。由于在描述标准治疗结果的临床试验中，老年患者，尤其是体弱患者的代表性不足，本文旨在综述直肠癌三联疗法的现有知识，重点关注可应用于体弱患者的直肠癌新治疗方法。
