Bunjo Zachary, Sammour Tarik
Colorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia.
Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, SA, Australia.
Ann Surg Oncol. 2025 Apr 22. doi: 10.1245/s10434-025-17299-5.
The management of locally advanced rectal cancer (LARC) has seen much development over recent decades. Neoadjuvant radiotherapy combined with high-quality total mesorectal excision saw improvements in locoregional control. With the advent of several key trials, neoadjuvant therapy for LARC has seen a shift toward total neoadjuvant therapy, with corresponding improvements in tumor response and survival outcomes. The collective pool of evidence has allowed for increasingly personalized treatment of LARC, with organ-preservation now an option for many. The aims of the review are to summarize the evolution of neoadjuvant therapy for LARC, highlight key studies informing contemporary best practices, navigate the complexity of options available, and present areas of ongoing development.
近几十年来，局部进展期直肠癌（LARC）的治疗取得了很大进展。新辅助放疗联合高质量的全直肠系膜切除术使局部区域控制得到改善。随着几项关键试验的出现，LARC的新辅助治疗已转向全新辅助治疗，肿瘤反应和生存结果也相应得到改善。大量证据使得LARC的治疗越来越个性化，现在许多患者可以选择保留器官。本综述的目的是总结LARC新辅助治疗的演变，突出为当代最佳实践提供依据的关键研究，梳理现有治疗方案的复杂性，并介绍正在发展的领域。
