医学
全直肠系膜切除术
结直肠癌
放射治疗
新辅助治疗
辅助放疗
化疗
模式治疗法
叙述性评论
临床实习
癌症
肿瘤科
外科
重症监护医学
内科学
物理疗法
乳腺癌
作者
Beatrice Borelli,Marco Maria Germani,Martina Carullo,Roberto Mattioni,B. Manfredi,A. Sainato,Piercarlo Rossi,Paola Vagli,Riccardo Balestri,P Buccianti,Luca Morelli,Carlotta Antoniotti,Chiara Cremolini,Gianluca Masi,Roberto Moretto
标识
DOI:10.1016/j.critrevonc.2023.103985
摘要
The multimodal approach with total mesorectal excision preceded by neoadjuvant (chemo)radiotherapy represented the mainstay treatment for locally advanced rectal cancer (LARC) for a long time. However, the benefit of adjuvant chemotherapy in terms of distant relapse reduction is limited. Recently, chemotherapy regimens administered before surgery and incorporated with (chemo)radiotherapy in total neoadjuvant treatment protocols have been established as new options in the management of LARC. Meanwhile, patients with clinical complete response to neoadjuvant treatment can benefit from organ preservation strategies, aimed at sparing surgery and long-term post-operative morbidities, while preserving an adequate disease control. However, the introduction of a non-operative management in clinical practice is a matter of debate with some concerns regarding the risk of local recurrence and long-term outcomes. In this review, we discuss how these recent advances are reshaping the multimodal management of localized rectal cancer and propose an algorithm to place them in the clinical practice.
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