[Adjuvant and perioperative neoadjuvant therapy for colorectal cancer].

Colorectal cancer is one of the most common malignant tumors in the world, threatening human health. The treatment strategy of stage II and stage III colorectal cancer has changed from surgery alone to multidisciplinary mode emphasizing perioperative treatment. The indication of adjuvant chemotherapy for stage II colon cancer is still defined by high-risk factors, but only microsatellite status and BRAF gene mutation can help predict efficacy of chemotherapy. Combined chemotherapy is the main adjuvant therapy for stage III colon cancer. The recommended course of adjuvant chemotherapy is 6 months. Based on the results of the IDEA study, the three-month CapeOX regimen (oxaliplatin and capecitabine) is recommended for the treatment of patients with T1-3 and N1 tumors. Neoadjuvant chemotherapy for locally advanced colon cancer is still in the exploratory stage of clinical trials. The difference between the treatment of rectal cancer and colon cancer lies in the application of radiotherapy. Chemoradiotherapy combined with TME (total mesorectal excision) surgery and adjuvant chemotherapy has become the standard treatment for locally advanced rectal cancer. Nowadays, the research hotspots in neoadjuvant therapy of rectal cancer include neoadjuvant chemotherapy and total neoadjuvant therapy (TNT). This article will review the progress of perioperative treatment for colorectal cancer.结直肠癌是最常见的恶性肿瘤之一，极大地威胁着人类的健康。Ⅱ期、Ⅲ期结直肠癌的治疗已经由手术治疗的单一模式转变为强调围手术期的多学科综合诊疗模式。Ⅱ期结肠癌的辅助化疗适应证目前仍以有无临床高危因素来界定，微卫星状态和BRAF基因突变检测对治疗方案的选择有一定的帮助;Ⅲ期结肠癌的辅助化疗以联合化疗为主，疗程为6个月;基于IDEA研究的结果，对T1~3、N1患者的治疗，美国国立综合癌症网络指南将3个月的CapeOX方案（奥沙利铂+卡培他滨）列入了推荐选择中；进展期结肠癌的新辅助化疗目前仍处于临床试验探索阶段。直肠癌的治疗较之结肠癌最大的区别在于放疗的应用，并且同步放化疗联合全直肠系膜切除术及辅助化疗的治疗方式已成为局部晚期直肠癌的金标准治疗模式；当前，在直肠癌新辅助治疗中的探索热点还包括直肠癌的新辅助化疗以及全程新辅助治疗（TNT）。.