摘要
术前同步放化疗后行全直肠系膜切除(TME)是目前局部进展期直肠癌的标准治疗方案。有关研究已证实,术前同步放化疗可使肿瘤缩小并降期,从而提高肿瘤的手术切除率,降低局部复发率,并提高病人的保肛率。然而,直肠癌根治手术伴随而来的是较高的并发症发生率和死亡风险,并且可能严重影响病人术后生活质量。鉴于术前同步放化疗可获得较高的肿瘤缓解率,一些学者提出对于放化疗后临床完全缓解的病例,可行局部切除的微创手术或仅给予密切观察的观点。
Neoadjuvant chemoradiotherapy （CRT） followed by radical surgery including total mesorectal excision （TME） is standard treatment in patients with locally advanced rectal cancer. The benefits of neoadjuvant CRT have been well documented and include tumor regression and downstaging associated with increased tumor respectability, reduced local recurrence and a higher rate of sphincter preservation. Radical surgery for rectal cancer carries a high risk of morbidity and mortality and can also greatly detract from a patient＇ s quality of life. In light of the significant response rates that can be achieved with preoperative CRT, some scholars have suggested limiting further surgical therapy to local excisionalone or to observation for patients with clinical complete response （cCR）. This article summarizes the latest development of management strategies for complete responders after neoadjuvant CRT for rectal cancer.
出处
《中国实用外科杂志》
CSCD
北大核心
2014年第1期33-36,共4页
Chinese Journal of Practical Surgery
基金
国家自然科学基金项目(81272766)
首都临床特色应用研究(Z121107001012130)
关键词
直肠癌
术前放化疗
完全缓解
等待观察
局部切除
rectal cancer
neoadjuvant chemoradiotherapy
complete response
wait-and-see
local excision
