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中华结直肠疾病电子杂志 ›› 2016, Vol. 05 ›› Issue (04) : 341 -343. doi: 10.3877/cma.j.issn.2095-3224.2016.04.013

所属专题: 文献

综述

直肠癌新辅助放化疗的探索
李帅1, 金晶1,()   
  1. 1. 100021 北京,国家癌症中心/中国医学科学院北京协和医学院肿瘤医院放疗科
  • 收稿日期:2016-05-11 出版日期:2016-08-25
  • 通信作者: 金晶
  • 基金资助:
    国家自然科学基金资助项目(No.81272510)

The exploration on neoadjuvant chemoradiation for the treatment of rectal cancer

Shuai Li1, Jing Jin1,()   

  1. 1. Department of Radiotherapy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
  • Received:2016-05-11 Published:2016-08-25
  • Corresponding author: Jing Jin
  • About author:
    Corresponding author: Jin Jing, Email:
引用本文:

李帅, 金晶. 直肠癌新辅助放化疗的探索[J]. 中华结直肠疾病电子杂志, 2016, 05(04): 341-343.

Shuai Li, Jing Jin. The exploration on neoadjuvant chemoradiation for the treatment of rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(04): 341-343.

对于局部晚期直肠癌,美国NCCN指南或欧洲ESMO指南均推荐术前放疗或放化疗联合全直肠系膜切除术(total mesorectal excision,TME)作为标准的治疗模式,使局部晚期直肠癌的治疗疗效取得了显著提高。为进一步降低远处转移率、提高生存率,目前对多种新辅助治疗的模式展开了探索,并取得初步成效。

Neoadjuvant radiotherapy or chemoradiotherapy combined with total mesorectal excision (TME) surgery have been recommend for local advanced rectal cancer in NCCN/ESMO guidelines, Because those treatments have improved the outcomes for local advanced rectal cancer patients. In order to decrease the distant metastasis and increase the survival rate for those patients, there are more and more researches which arranged the radiotherapy and chemotherapy in different ways. What is so exciting is that the preliminary result is quite well.

表1 Clinical Trail注册的局部晚期直肠癌新辅助放化疗模式的Ⅱ/Ⅲ期研究
研究类型 发起人 拟病例数 拟研究时间 拟研究方案 研究终点
Ⅱ期随机对照研究 Harbin Medical University 80 2013.7 -2018.1 a.同步放化疗
b.化疗+同步放化疗+化疗
3年DFS 3年复发率R0切除率pCR
Ⅱ/Ⅲ期随机对照研究 National Cancer Institute (NCI) 1060 2012.1 -2017.7 a.诱导化疗±放化疗+手术+化疗
b.同步放化疗+手术+化疗
Ⅱ:R0 / Ⅲ:DFS pCR、OS、AE
Ⅱ期随机对照研究 Grupo Espanol Multidisciplinario del Cancer Digestivo 180 2015.1 -2020.3 a.新辅助化疗和Aflibercept+同步放化疗+手术
b.新辅助化疗+同步放化疗+手术
pCR R0切除率、术后并发症3年DFS复发率
Ⅱ期单臂研究 中山大学 84 2014.8 -2017.8 FOLFOXIRI(4Cycle)+TME 术后病理Stage0/I
Ⅱ期单臂研究 意大利 50 2013.7 -2018.7 FOLFOX4+Tomo放疗+FOLFOX4+TME+FOLFOX 治疗毒性、pCR
Ⅱ期单臂研究 中山大学 45 2013.3 -2020.3 XELOX和贝伐+贝伐和XELOX同步放化疗+TME手术 TRG分级5年OS治疗毒性
Ⅲ期随机对照研究 中山大学 556 2014.1 -2023.1 a.标准术前同步放化疗
b.诱导化疗+放化疗+间歇化疗
5年OS/DFS肿瘤降期率
Ⅲ期随机对照研究 UNICANCER 460 2012.1 -2022.1 a.同步放化疗+手术
b.新辅助化疗+同步放化疗+手术
3年DFS 7年OS
Ⅲ期随机对照研究 中山大学 648 2014.8 -2024.6 a.新辅助化疗+手术+化疗
b.同步放化疗+手术+化疗
5年局部复发率5年DFS/OS、pCR
Ⅲ期随机对照研究 美国MSKCC 222 2013.11 -2017.11 a.新辅助化疗+同步放化疗
b.同步放化疗+新辅助化疗
3年DFS治疗毒副反应
Ⅲ期随机对照研究 波兰RAPIDO 885 2011.6 -2019.6 a. 5X5+XELOX+手术
b.同步放化疗+手术
3年DFS 5年OS、pCR CRM阴性率
Ⅲ期随机对照研究 德国CAOAROAIO-12 304 2015.2 -2022.5 a.新辅助化疗+同步放化疗
b.同步放化疗+新辅助化疗
pCR术后并发症、降期率R0切除率、RFS、OS
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