新辅助放化疗后手术时机选择对进展期直肠癌患者预后影响的研究进展.PDFVIP

中国癌症杂志 2015年第25卷第8期 《 》 CHINA ONCOLOGY 2015 Vol.25 No.8 635 新辅助放化疗后手术时机选择对进展期 直肠癌患者预后影响的研究进展 张　斌 综述 ，汪　昱 审校 上海交通大学附属第六人民医院普外科，上海 200233 　　［摘要］　进展期直肠癌行新辅助放化疗(neoadjuvant chemoradiotherapy，nCRT)后的延期手术可以增 ~ 加根治切除机会，降低局部复发，同时改善患者总体生存率。常规的术前放化疗与手术之间的时间间隔为4 6 ~ 周，延长手术时间间隔可以增加肿瘤退缩的程度，但是超过6 8周也可能会增加手术难度、手术并发症发生率 及肿瘤复发或转移的风险。回顾分析相关文献，从肿瘤缓解率、预后、患病率和死亡率等方面对nCRT后延期手 术时机选择对预后影响的研究进展进行综述。 　　 ［关键词］　新辅助治疗；手术时机；局部进展期直肠癌 　　DOI: 10.3969/j.issn.1007-3969.2015.08.013 　　中图分类号：R735.3+7　　文献标志码：A　　文章编号：1007-3639(2015)08-0635-06 Study of impact of operation time interval after neoadjuvant chemoradiotherapy for locally progressed rectal patients’ outcome ZHANG Bin, WANG Yu (Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China) Correspondence to: WANG Yu E-mail: wangyu11122@ Abstract Neoadjuvant chemoradiotherapy (nCRT) is used to downstage locally advanced rectal cancer before 　　［ ］ surgery, in order to increase the chance of radical resection, reduce local recurrence, and improve overall survival. Accumulating data suggest that tumor response to nCRT is time dependent. A delay between nCRT and surgery may increase the proportion of patients that achieve a favorable response, and 4-6 weeks are considered to be a universal interval. However, delayed surgery beyond 6-8 weeks may increase the technical difficulty, and the risks of surgical complications and recurrence or metastasis. This article briefly reviews the relevant literature to evaluate the efficiency and safety of delayed surgery.