关键词: 结直肠癌, 新辅助, 化疗, 放疗

Abstract:

Interpretations of the changes of colorectal cancer neo-adjurant and salvage chemotherapy regimen in 2012 version NCCN guideline        BA Yi. Department of Gastrointestinal Oncology ，Tianjin Medical University Cancer Hospital，Tianjin300060，China
Abstract    Some changes have been made on the colorectal cancer neo-adjuvant and the salvage chemotherapy regimens in the 2012 version of NCCN guideline. The combination of FOLFOX with cetuximab was removed from the salvage regimens and non-conversional neo-adjuvant chemotherapy regimens for KRAS wild type advanced colorectal cancer patients, because two phase Ⅲ randomized control trials presented with negative results. However, there are still rationales for the combination of oxaliplatin based regimens with EGFR antibody in the conversional neo-adjuvant chemotherapy. The combination of capecitabine with bevacizumab is well tolerated, which is recommended as one of the initial treatment options for the patients who can’t tolerate intensive chemotherapy with advanced colorectal cancer. The concurrent chemoradiotherapy with capecitabine or infusional 5fluorouracil is recommended as the prior option for the patients with stage Ⅱ or Ⅲ rectal cancer. Capecitabine or infusional 5fluorouracil concurrent with radiotherapy is the prior neo-adjuvant regimen for the patients with rectal cancer, based on the results of three trials. Oxaliplatin can’t produce additional short term benefits.

Key words: colorectal cancer, neo-adjuvant, chemotherapy, radiotherapy