整体新辅助治疗直肠癌:使用哪些方案?
Kentaro Ochiai1,2, Neal Bhutiani1, Atsushi Ikeda1
1Department of Colon and Rectal Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Cancers
|June 19, 2024
概括
对直肠癌的全新辅助疗法 (TNT) 结合了手术前的化疗和放射治疗. 本综述探讨了各种TNT疗法,以指导临床医生优化治疗以获得更好的结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 全新辅助疗法 (TNT) 整合了直肠癌手术前的全身化疗和 (化疗) 放射疗法.
- 这种方法旨在提高治疗坚持,促进瘤回归,促进器官保存,并改善整体瘤结果.
- TNT的景观是动态的,正在进行的临床试验产生了新的数据和不同的治疗策略.
研究的目的:
- 审查关于各种整体新辅助疗法治疗直肠癌的现有证据.
- 根据个体患者的风险因素和瘤特征,为定制TNT提供决策框架.
- 帮助临床医生了解多学科护理中不同TNT方法的好处和缺点.
主要方法:
- 对临床试验的综合文献综述和关于整体新辅助治疗直肠癌的证据.
- 分析不同的TNT组合,包括诱导/巩固化疗和不同的放射治疗方案.
- 为个性化TNT选择制定决策流程图.
主要成果:
- 存在多种TNT疗法,不同的是化疗类型 (三重/双重) 和放射治疗持续时间 (长/短疗程).
- 证据正在迅速发展,在最佳的TNT疗法上没有普遍的共识.
- 提出了一个流程图,以帮助根据瘤位置和风险分层选择适当的TNT策略.
结论:
- 总的新辅助疗法代表了直肠癌管理的重大进步.
- 了解不同TNT方案的细微差别对于有效的临床决策至关重要.
- 以风险评估为指导的个性化治疗策略对于最大限度地发挥TNT的益处至关重要.
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