摘要
直肠癌新辅助放化疗后部分患者可以达到临床完全缓解(cCR)。cCR患者采用等待观察策略可以取得与根治性手术类似的疗效,而且避免了手术并发症,显著改善患者生活质量,正日益受到关注。虽然现有研究结果支持等待观察策略安全可行,但仍缺乏高级别循证医学证据。等待观察策略实施中还有很多问题需要进一步明确,包括远期肿瘤学疗效、cCR的诊断和评价标准、适宜患者的选择、观察期间的随访策略以及肿瘤局部再生的处理方法等。本文将根据现有文献结果结合本中心临床经验对上述问题加以阐述。
Some patients with rectal cancer can achieve clinical complete response(cCR)after neoadjuvant chemoradiotherapy.The watch and wait strategy for cCR patients can achieve similar curative effects as radical surgery,avoid surgical complications,and significantly improve the quality of life of patients,which is attracting increasing attention.Although the existing research results support that the watch and wait strategy is safe and feasible,there is still a lack of high-level evidence-based medicine evidence.There are still many issues in the implementation of the watch and wait strategy that need to be further clarified,including long-term oncology efficacy,cCR diagnosis and evaluation criteria,appropriate patient selection,follow-up strategies during the observation period,and treatment methods for local tumor regeneration.This article will explain the above problems based on the results of the existing literature and the clinical experience of our center.
作者
陆君阳
Lu Junyang(Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)
出处
《国际外科学杂志》
2021年第8期510-513,共4页
International Journal of Surgery
基金
首都临床特色应用研究与成果推广项目(216110000516014)。
关键词
直肠肿瘤
新辅助放化疗
临床完全缓解
等待观察策略
Rectal neoplasms
Neoadjuvant chemoradiotherapy
Clinical complete response
Watch and wait strategy
