摘要
目的论述近年来术前放化疗即新辅助治疗在中低位直肠癌综合治疗模式中的作用。方法结合近期文献及笔者单位的经验,从外科治疗角度,就新辅助治疗的重点关注问题进行阐述。结果新辅助治疗经过20余年的发展,总剂量50Gy的长程放疗显示出较多优势。新辅助治疗在肿瘤降期、术后局部控制率方面取得明显优势;但对提高保肛手术几率目前还有不同看法;同时大量的研究结果没有发现该治疗方式能提高患者的远期存活率;目前还没有手段预测其治疗敏感性。结论对于进展期中低位直肠癌,新辅助治疗仍是提高手术R0切除率、降低术后局部复发的有效治疗方式。
Objective To discuss the important role of preoperative chemoradiotherapy in the treatment of mid-low rectal cancer. Methods From the surgical point of view,the evidences from clinic trials in literatures of recent years and also from the results of our single institution were analyzed. Results Preoperative radiotherapy with total dosage of 50 Gy had showed more and more advantages in the past two decades. Preoperative radiotherapy with concomitant chemotherapy had definite effects in downing stage and improving local control,while its role in sphincter preserving kept in controversy. However,this combined preoperative therapies had not improved long-term survival in rectal cancer. By now,there were no proper indicators to predict the effects of therapies. Conclusion Preoperative chemoradiotherapy is still the only way to improve the rate of R0 resection and decrease the rate of local currence after surgery for patients with mid-low advanced rectal cancer.
出处
《中国普外基础与临床杂志》
CAS
2010年第9期906-909,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
直肠癌
术前放化疗
新辅助治疗
Rectal cancer
Preoperative chemoradiotherapy
Neoadjuvant therapy
