摘要
目的 总结低位直肠癌在器官功能保留方面的临床研究进展,探讨其最佳治疗方案,为今后临床研究提供参考和思路。方法 使用PubMed及中国知网数据库检索系统,以“低位直肠癌”和“保留肛门”为中文关键词,“low rectal cancer”和“organ preservation”为英文检索词,检索2013-03-31-2023-04-01相关文献。共检索到英文文献105条,中文文献9篇。纳入标准:(1)早期低位直肠癌治疗策略相关研究;(2)全新辅助治疗、强化同步放化疗以及等待时间窗在局部晚期低位直肠癌中的研究进展;(3)非手术治疗“等待观察策略”和局部切除术的开展及其面临的挑战和机遇。排除标准:保肛手术研究以及数据陈旧的相关文献。最终纳入66篇英文文献进行分析。结果 针对早期低位直肠癌,例如cT_(1)N_(0)M_(0),局部切除±术后放疗可达到与根治手术相同的肿瘤学结局,而对于大部分Ⅱ/Ⅲ期局部进展期低位直肠癌,手术根治性切除率低、术后局部复发率高。随着全新辅助治疗等研究结果初见成效,低位直肠癌患者的保肛率不断提高。结论 在多学科诊疗模式下,全球各中心器官保留方面的临床研究十分活跃,例如全新辅助治疗、强化同步放化疗以及非手术治疗“等待观察策略”和局部切除术的开展,其初步研究成果给低位直肠癌患者带来新的曙光。但如何优化个体化治疗方案需在今后的临床研究中进一步探讨。
Objective To summarize the clinical research progress of organ function preservation in low rectal cancer in recent years,aiming at exploring the best treatment scheme and providing references and ideas for clinical research in the future.Methods PubMed and China National Knowledge Infrastructure(CNKI) database retrieval system were used to search the related literature from 2013-03-31 to 2023-04-01 with "low rectal cancer and anus preservation" as the Chinese keywords,"low rectal cancer and organ preservation " as the English keywords.A total of 105 English articles and 9 Chinese articles were retrieved.Inclusion criteria:(1) related research on treatment strategies of early low rectal cancer;(2) research progress of total neo-adjuvant therapy:enhanced concurrent radiochemotherapy and waiting-time window in locally advanced low rectal cancer;(3) the development of non-operative treatment " watch-and-wait strategy" and local resection surgery,as well as their facing challenges and opportunities.Exclusion criteria:studies on sphincter-preserving surgery and related literature with outdated data.Finally,66 English literature were included for analysis.Results For early low rectal cancer,such as cT_(1)N_(0)M_(0),local resection±postoperative radiotherapy can achieve the same oncological outcome as radical surgery,but for most locally advanced low rectal cancer in stage Ⅱ/Ⅲ,the radical resection rate is low and the postoperative local recurrence rate is high.With the initial results of total neo-adjuvant therapy and other research results,the anus preservation rate of patients with low rectal cancer continues to improve.Conclusions Under the multidisciplinary treatment mode,the clinical research on organ preservation in various centers around the world is very active,such as total neo-adjuvant therapy,enhanced concurrent chemoradiotherapy as well as the development of non-operative treatment "watch-and-wait strategy" and local resection surgery.The preliminary research results cast a new light on the patients wi
作者
蒲文吉
金晶
PU Wenji;JIN jing(Department of Medicine of Shenzhen University,Shenzhen 518055,China;Department of Radiotherapy,National Cancer Center/National Cancer Clinical Medical Research Center/Shenzhen Hospital,Cancer Hospital of Peking Union Medical College,Chinese Academy of Medical Sciences,Shenzhen 518116,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第16期1005-1012,共8页
Chinese Journal of Cancer Prevention and Treatment
基金
深圳市医学重点学科建设经费资助(SZXK013)
深圳市“医疗卫生三名工程”项目(SZSM201612063)
深圳市恶性肿瘤临床医学研究中心(深科技创新[2021]287号)。
关键词
低位直肠癌
器官保留
局部切除
全新辅助治疗
同步放化疗
等待观察策略
综述文献
low rectal cancer
organ preservation
local excision
total neo-adjuvant therapy
concurrent chemoradiotherapy
watch-and-wait strategy
review literature
