观察和等待的持续发展
Mikhael Belkovsky1, Ali Alipouriani2, Arielle E Kanters2
1Department of Surgery, University of Massachusetts, Worcester, Massachusetts.
Clinics in colon and rectal surgery
|June 12, 2025
概括
在新辅助化学辐射治疗 (nCRT) 后使用临床完整反应 (cCR) 的直肠癌观察和等待 (W&W) 方法,显示出高生存率. 这种非手术策略为选定的患者提供了降低的发病率,而不会影响结果.
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:
- 观察和等待 (W&W) 是一种正在发展中的直肠癌非手术治疗策略.
- 它依赖于在新辅助化学辐射治疗 (nCRT) 后实现临床完整反应 (cCR),以预测病理完整反应 (pCR).
- 随着nCRT疗法疗程效率的提高,W&W已成为某些患者的可行选择.
研究的目的:
- 审查W&W的直肠癌战略的历史发展和有效性.
- 根据最近的临床证据,为W&W提供当前的建议.
- 评估W&W的瘤结果和生活质量影响.
主要方法:
- 关于直肠癌的W&W的历史和当代研究的文献综述.
- 对临床试验数据的分析,重点关注应答率和生存结果.
- 评估患者报告的结果和与W&W相关的发病率.
主要成果:
- 在nCRT后实现cCR是W&W候选人的pCR可靠指标.
- 获得cCR的W&W管理的患者显示5年无病生存率为85-92%.
- W&W提供了显著降低与治疗相关的发病率和改善生活质量的潜力.
结论:
- 观察和等待策略是安全有效的非手术选择,用于直肠癌患者实现cCR后nCRT.
- W&W可以保持生活质量,减少外科手术发病率,而不会对生存产生负面影响.
- 持续的研究和标准化的协议对于优化W&W实施至关重要.
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