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中华结直肠疾病电子杂志

中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (05) : 363 -371. doi: 10.3877/cma.j.issn.2095-3224.2023.05.002

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低位直肠癌新辅助放化疗应用的焦点问题
邹敏, 徐明, 吴伟强, 归明彬, 高峰†()   
  1. 730050　兰州，联勤保障部队第940医院结直肠肛门外科
  • 收稿日期:2022-12-04 出版日期:2023-10-25
  • 通信作者: 高峰
  • 基金资助:
    甘肃省自然科学基金项目(17JR5RA331); 中央高校创新团队项目(31920200016)

Focus of neoadjuvant radiotherapy and chemotherapy for low rectal cancer

Min Zou, Ming Xu, Weiqiang Wu, Mingbin Gui, Feng Gao†()   

  1. Department of Colorectal & Anal Surgery, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China
  • Received:2022-12-04 Published:2023-10-25
  • Corresponding author: Feng Gao
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邹敏, 徐明, 吴伟强, 归明彬, 高峰. 低位直肠癌新辅助放化疗应用的焦点问题[J]. 中华结直肠疾病电子杂志, 2023, 12(05): 363-371.

Min Zou, Ming Xu, Weiqiang Wu, Mingbin Gui, Feng Gao. Focus of neoadjuvant radiotherapy and chemotherapy for low rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(05): 363-371.

进展期低位直肠癌经术前新辅助治疗后肿瘤达到临床完全缓解的患者可建议行观察等待（W&W）治疗策略，从而达到保留器官的目的。然而只有部分患者适合此治疗策略，而且在实施过程中仍有许多难以决策的问题。本文对低位直肠癌新辅助放化疗策略中的如何准确判断临床完全缓解、增加临床完全缓解率、预测临床缓解、肿瘤局部再生后如何处理、是否会增加远处转移以及对新辅助治疗效果不佳应该如何应对等焦点问题进行综述，以期为直肠癌保器官治疗决策提供参考。

关键词: 直肠肿瘤, 新辅助治疗, 器官保留, 临床完全缓解

For patients with low local advanced rectal cancer who have achieved complete clinical response after preoperative neoadjuvant therapy, it is recommended to watch and wait (W&W) for treatment strategy, so as to achieve the purpose of organ preservation. However, only some patients are suitable for this treatment strategy, and there are still many difficult decisions in the implementation process. This article reviews the focus issues in neoadjuvant chemoradiotherapy strategy for low rectal cancer, such as how to accurately judge the clinical complete remission rate, how to increase the clinical complete remission rate, how to predict the clinical remission rate, how to deal with the tumor after local regeneration, whether it will increase distant metastasis, and how to deal with the poor effect of new adjuvant therapy, so as to provide reference for the decision-making of organ conserving therapy for rectal cancer.

Key words: Rectal neoplasms, Neoadjuvant therapy, Organ preservation, Clinical complete response
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