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在早期直肠癌中,全新辅助治疗有没有作用?

Kamil Erozkan^1,2, Metincan Erkaya¹, Jacob A Miller³

¹Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.

Langenbeck's archives of surgery

|November 11, 2025

概括

总的新辅助治疗 (TNT) 对第一阶段直肠癌 (S1RC) 是有前途的,具有很高的完整反应和器官保存率. 这种方法可能是选择患者的手术可行的替代方案,特别是低的瘤.

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:

第一阶段直肠癌 (S1RC) 的标准治疗包括手术,但这可能导致功能障碍和永久性结肠直肠切除等不良结果.
低位置的S1RC带来了特殊的挑战,增加了手术后功能缺陷的风险.
全新辅助治疗 (TNT) 正在成为选择S1RC患者的潜在替代方案.

研究的目的:

为了评估全新辅助治疗 (TNT) 在I期直肠癌 (S1RC) 患者的疗效,这些患者拒绝了标准手术干预.
评估接受TNT的S1RC患者的完整反应和器官保存率.

主要方法:

在2015年至2023年期间选择TNT的S1RC患者的回顾性评估,不包括那些经历了全腹腔切除术 (TME) 的患者.
分析了两组患者:那些接受TNT后化学辐射与部分反应,和那些接受TNT后S1RC.局部切除.
测量的主要结果是完整反应和器官保存率.

主要成果:

16名S1RC患者接受了TNT,其中93.7%的患者获得了完全反应,87.5%的患者获得了器官保存.
在化学辐射后接受TNT治疗的组中,11名患者中有9人实现了完全的临床反应.
在局部切除后接受TNT治疗的患者在20个月的中位数随访期间没有出现局部复发或远程转移.

结论:

选择性使用全新辅助治疗 (TNT) 是治疗第一阶段直肠癌 (S1RC) 的有希望的策略,特别是在低层瘤中.
通过TNT,可以达到完全反应和器官保存的高率,从而有可能避免彻底的手术.
需要进一步进行大规模的前性研究,并进行更长时间的后续研究,以证实这些发现和标准化方案.

关键词:

早期的直肠癌是什么?器官的保存器官的保存第一个阶段的直肠癌.在TNT上播放.

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