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新辅助治疗后达到临床完全缓解的患者管理及展望:关于局部晚期直肠癌

A management of patients achieving clinical complete response after neoadjuvant therapy and perspectives: on locally advanced rectal cancer.

作者信息

Liu Yu-Xin, Yang Xin-Rong, Peng Lan-Qing, Li Zhuo-Hong

机构信息

Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

出版信息

Front Oncol. 2025 Jan 8;14:1450994. doi: 10.3389/fonc.2024.1450994. eCollection 2024.

Abstract

Neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) and selective use of adjuvant chemotherapy is currently considered the standard of care for locally advanced rectal cancer (LARC). Despite this, the concept of organ preservation is gradually challenging this approach. The management of complete clinical remission (cCR) lacks international consensus, leading scholars to develop their own perspectives based on well-designed studies and long-term data from large multicenter cohorts. To ensure appropriate treatment, this review focuses on the choice of neoadjuvant therapy, criteria for defining cCR, and treatment strategies for patients who achieve cCR after neoadjuvant therapy. By providing guidance on the accurate management of LARC patients after cCR, this review aims to prevent over- or under-treatment.

摘要

新辅助放化疗(nCRT)后行全直肠系膜切除术(TME)并选择性使用辅助化疗目前被认为是局部进展期直肠癌(LARC)的标准治疗方案。尽管如此,器官保留的概念正逐渐对这种方法提出挑战。完全临床缓解(cCR)的管理缺乏国际共识,这促使学者们基于精心设计的研究以及来自大型多中心队列的长期数据形成自己的观点。为确保进行适当的治疗,本综述重点关注新辅助治疗的选择、cCR的定义标准以及新辅助治疗后达到cCR的患者的治疗策略。通过为cCR后LARC患者的准确管理提供指导,本综述旨在防止过度治疗或治疗不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05a3/11750660/6d3dd23a8e62/fonc-14-1450994-g001.jpg

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