中国实用外科杂志

中国实用外科杂志

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局部进展期直肠癌新辅助放化疗后手术最佳间隔时间选择

曹    键，叶颖江，王    杉   

  1. 北京大学人民医院胃肠外科，北京100044
  • 出版日期:2017-06-01 发布日期:2017-05-31

  • Online:2017-06-01 Published:2017-05-31

摘要：

目前，局部进展期直肠癌（locally advanced rectal cancer，LARC）标准治疗模式是术前新辅助放化疗（neoadjuvant chemoradiotherapy，nCRT），然后行根治性手术切除并配合术后辅助化疗。但新辅助治疗后到手术之前的最佳间隔时间仍不明确。适当延长手术间期（12周内）可提高肿瘤降期率及病理完全缓解（pathologic complete response， pCR）率；但延长手术间期可能会增加手术难度、降低手术质量；延长手术间期能否改善长期预后尚无定论。应根据病人的病情制定个体化的治疗策略。

关键词: 局部进展期直肠癌, 新辅助放化疗, 手术, 最佳间隔时间

Abstract:

Optimal timing of surgery following neoadjuvant chemoradiotherapy in locally advanced rectal cancer                 CAO Jian, YE Ying-jiang，WANG Shan. Department of Gastrointestinal Surgery, Beijing University People’s Hospital, Beijing 100044, China
Corresponding author: YE Ying-jiang, E-mail: yjye101@sina.com
Abstract    The standard treatment for locally advanced rectal cancer（LARC） is curative surgical resection，combined with neoadjuvant chemoradiation therapy （nCRT） and additional adjuvant therapy if indicated. But the optimal interval between CRT and surgery is still unclear. Prolonging the interval to 12 weeks may lead to significantly higher rates of tumor downstaging and pathologic complete response（pCR）. However，delayed surgery may increase the technical difficulty，and reduce the quality of surgery. Whether prolonged interval can improve long-term outcome is uncertain. Individualized treatment strategies should be based on the patient's condition.

Key words: locally advanced rectal cancer, neoadjuvant chemoradiotherapy, surgery, optimal time interval