对于直肠癌的新辅助化学辐射治疗后的非手术管理和局部切除
Gianluca Rizzo1, Luca E Amodio2, Giorgio D'Annibale2
1Unit of Digestive and Colorectal Surgery, Ospedale Isola Tiberina Gemelli Isola, Università Cattolica del Sacro Cuore, Rome, Italy - g.rizzo7879@gmail.com.
对于局部晚期的直肠癌,像非手术管理 (NOM) 和局部切除 (LE) 这样的器官节约方法是化学辐射治疗 (CRT) 后传统手术的新兴替代方案. 本综述评估了它们的安全性和有效性,与标准的全腹腔切除术 (TME) 相比.
科学领域:
- 在瘤学瘤学.
- 外科胃肠道外科手术
- 辐射瘤学 辐射瘤学
背景情况:
- 局部发达的外皮质直肠癌是一个重大的临床挑战.
- 标准治疗包括新辅助化学辐射疗法 (CRT),其次是彻底的手术切除与全腹腔切除 (TME).
- 最近的进展包括微创手术和对精选患者的器官节省策略,为CRT实现完全反应.
研究的目的:
- 批判性地检查非手术治疗 (NOM) 和局部切除 (LE) 的疗效和瘤安全性.
- 为了比较NOM和LE与标准的TME在后neoadjuvantCRT直肠癌患者.
- 提供对直肠癌新型管理策略的全面概述.
主要方法:
- 对现有文献进行系统的审查和批判性分析.
- 对NOM,LE和TME的瘤结果和安全概况的评估.
- 对每个管理方法的优缺点进行分析.
主要成果:
- 对于高度精选的直肠癌患者来说,NOM和LE是可行的器官节省选择,这些患者对新辅助CRT有完整的反应.
- 与TME相比,这些方法在患病率和生活质量方面提供了潜在的好处.
- 瘤安全性和长期疗效需要继续调查和与TME进行比较.
结论:
- NOM和LE代表着在CRT后对直肠癌管理的不断发展,潜在的少入侵策略.
- 仔细的患者选择对于成功实施器官节约方法至关重要.
- 需要进一步的研究来确定最终的瘤结果,并优化患者选择标准.
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