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中华结直肠疾病电子杂志 ›› 2016, Vol. 05 ›› Issue (06) : 458 -462. doi: 10.3877/cma.j.issn.2095-3224.2016.06.001

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肿瘤退缩分级标准的对比及其在直肠癌诊治中的应用进展
谭伊诺1, 陈海燕1, 丁克峰1,()   
  1. 1. 310009 杭州,浙江大学医学院附属第二医院肿瘤外科
  • 收稿日期:2016-07-19 出版日期:2016-12-25
  • 通信作者: 丁克峰
  • 基金资助:
    2014年中国国家卫生行业公益性基金项目(No.201402015); 国家自然科学基金项目(No.81272455,81472664); 浙江省重点研发项目(No.2016CG1360721)

Criteria of tumor regression grade and its application in diagnosis and treatment of rectal cancer

Yinuo Tan1, Haiyan Chen1, Kefeng Ding1,()   

  1. 1. Department of Surgical Oncology, The Second Affiliated Hospital of Zhejiang Medical University, Hangzhou 310009, China
  • Received:2016-07-19 Published:2016-12-25
  • Corresponding author: Kefeng Ding
  • About author:
    Corresponding author: Ding Kefeng, Email:
引用本文:

谭伊诺, 陈海燕, 丁克峰. 肿瘤退缩分级标准的对比及其在直肠癌诊治中的应用进展[J]. 中华结直肠疾病电子杂志, 2016, 05(06): 458-462.

Yinuo Tan, Haiyan Chen, Kefeng Ding. Criteria of tumor regression grade and its application in diagnosis and treatment of rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(06): 458-462.

随着新辅助治疗在直肠癌中的规范化推广,肿瘤退缩分级(TRG)标准逐渐引起广泛关注和重视。多项研究证实TRG与直肠癌患者新辅助治疗反应、生存预后有一定相关性,在患者生存预测、随访和临床诊疗策略等方面均有应用前景,甚至也有报道考虑将其纳入临床试验替代终点。但是目前TRG标准各异,尚未统一化、规范化,故本文旨在对目前常见TRG标准进行汇总对比,并进一步探讨其在直肠癌诊治中的临床应用。

Along with the neoajuvant treatment popularized in rectal cancer treatment, tumor regression grade (TRG) has gradually attracted broad attention. Several studies have validated that TRG correlated well with neoajuvant treatment response and prognosis of patients, thus TRG has broad application prospect in prognosis prediction, follow-up and clinical decision, some other researches began to consider it as a surrogate endpoint in clinical trials. However, different systems of TRG couldn′t be unified and standardized. This review was to make a comparison of several popular systems of TRG and explore the clinical application of TRG in rectal cancer treatment.

表1 目前多种TRG分级的汇总对比
[1]
Becker K,Mueller JD,Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy[J]. Cancer, 2003, 98(7): 1521-1530.
[2]
Dworak O,Keilholz L and Hoffmann A. Pathological features of rectal cancer after preoperative radiochemotherapy[J]. Int J Colorectal Dis, 1997, 12(1): 19-23.
[3]
Mandard AM,Dalibard F,Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations[J]. Cancer, 1994, 73(11): 2680-2686.
[4]
Rodel C,Martus P,Papadoupolos T, et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer[J]. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 2005, 23(34): 8688-8696.
[5]
Wheeler JM,Warren BF,Mortensen NJ, et al. Quantification of histologic regression of rectal cancer after irradiation: a proposal for a modified staging system[J]. Diseases of the colon and rectum, 2002, 45(8): 1051-1056.
[6]
Quah HM,Chou JF,Gonen M, et al. Pathologic stage is most prognostic of disease-free survival in locally advanced rectal cancer patients after preoperative chemoradiation[J]. Cancer, 2008, 113(1): 57-64.
[7]
Zhang LN,Xiao WW,Xi SY, et al. Pathological Assessment of the AJCC Tumor Regression Grading System After Preoperative Chemoradiotherapy for Chinese Locally Advanced Rectal Cancer[J]. Medicine, 2016, 95(3): e2272.
[8]
Wheeler JM,Dodds E,Warren BF, et al. Preoperative chemoradiotherapy and total mesorectal excision surgery for locally advanced rectal cancer: correlation with rectal cancer regression grade[J]. Diseases of the colon and rectum, 2004, 47(12): 2025-2031.
[9]
Pucciarelli S,Toppan P,Friso ML, et al. Complete pathologic response following preoperative chemoradiation therapy for middle to lower rectal cancer is not a prognostic factor for a better outcome[J]. Diseases of the colon and rectum, 2004, 47(11): 1798-1807.
[10]
Maas M,Nelemans PJ,Valentini V, et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data[J]. The Lancet Oncology, 2010, 11(9): 835-844.
[11]
Patel UB,Taylor F,Blomqvist L, et al. Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience[J]. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 2011, 29(28): 3753-3760.
[12]
Pucciarelli S,De Paoli A,Guerrieri M, et al. Local excision after preoperative chemoradiotherapy for rectal cancer: results of a multicenter phase II clinical trial[J]. Diseases of the colon and rectum, 2013, 56(12): 1349-1356.
[13]
Habr-Gama A,Sabbaga J,Gama-Rodrigues J, et al. Watch and wait approach following extended neoadjuvant chemoradiation for distal rectal cancer: are we getting closer to anal cancer management?[J]. Diseases of the colon and rectum, 2013, 56(10): 1109-1117.
[14]
Maas M,Beets-Tan RG,Lambregts DM, et al. Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer[J]. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 2011, 29(35): 4633-4640.
[15]
Bosset JF,Collette L,Calais G, et al. Chemotherapy with preoperative radiotherapy in rectal cancer[J]. The New England journal of medicine, 2006, 355(11): 1114-1123.
[16]
Kockerling F,Raymond MA,Altendorf-Hofmann A, et al. Influence of surgery on metachronous distant metastases and survival in rectal cancer[J]. Journal Of Clinical Oncology, 1998, 16(1): 324-329.
[17]
Glynne-Jones R,Mawdsley S,Pearce T, et al. Alternative clinical end points in rectal cancer--are we getting closer?[J]. Annals of oncology: official journal of the European Society for Medical Oncology / ESMO, 2006, 17(8): 1239-1248.
[18]
De Gruttola VG,Clax P,DeMets DL, et al. Considerations in the evaluation of surrogate endpoints in clinical trials: Summary of a National Institutes of Health Workshop[J]. Controlled Clinical Trials, 2001, 22(5): 485-502.
[19]
Buyse M and Molenberghs G. Criteria for the validation of surrogate endpoints in randomized experiments[J]. Biometrics, 1998, 54(3): 1014-1029.
[20]
Bosset JF,Calais G,Mineur L, et al. Preoperative radiation (Preop RT) in rectal cancer: Effect and timing of additional chemotherapy (CT) 5-year results of the EORTC 22921 trial[J]. Journal Of Clinical Oncology, 2005, 23(16): 247S-247S.
[21]
Conroy T,Bonnetain F,Chapet O, et al. Preoperative (preop) radiotherapy (RT)+5FU/folinic acid (FA) in T3, 4 rectal cancers: Preliminary results of the FFCD 9203 randomized trial[J]. Journal Of Clinical Oncology, 2004, 22(14): 276S-276S.
[22]
Sauer R,Becker H,Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer[J]. New England Journal Of Medicine, 2004, 351(17): 1731-1740.
[23]
Gerard J,Bonnetain F,Conroy T, et al. Preoperative concurrent chemoradiotherapy (CT-RT) improves local control in T3-4 rectal cancers. Results of the FFCD 9203 randomized trial[J]. Ejc Supplements, 2005, 3(2): 170.
[24]
Bosset J-F,Collette L,Calais G, et al. Chemotherapy with preoperative radiotherapy in rectal cancer[J]. New England Journal Of Medicine, 2006, 355(11): 1114-1123.
[25]
Sargent DJ,Patiyil S,Yothers G, et al. End points for colon cancer adjuvant trials: observations and recommendations based on individual patient data from 20, 898 patients enrolled onto 18 randomized trials from the ACCENT Group[J]. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2007, 25(29): 4569-4574.
[26]
Guillem JG,Chessin DB,Cohen AM, et al. Long-term oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer[J]. Annals of surgery, 2005, 241(5): 829-836; discussion 836-828.
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