[对于直肠癌的全新辅助疗法的当前概念]
Claus Rödel1, Maximilian Fleischmann2, Markus Diefenhardt2
1Klinik für Strahlentherapie, Universitätsklinikum Frankfurt am Main, Goethe-Universität Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Deutschland. croedel@med.uni-frankfurt.de.
Chirurgie (Heidelberg, Germany)
|February 10, 2026
概括
总的新辅助疗法 (TNT) 改善了直肠癌的结果,包括无病生存率. 这种方法是推的,特别是对于高风险患者,并支持缓解后的器官保存策略.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 辐射疗法 辐射疗法
背景情况:
- 总的新辅助疗法 (TNT) 涉及术前的全身治疗,用于直肠癌的放射治疗或化学放射治疗.
- TNT可以作为诱导或巩固疗法给予.
- 随机试验表明,TNT与标准的新辅助化学放射治疗和手术相比,改善了瘤反应和无疾病生存率.
研究的目的:
- 总结结直肠癌治疗中全新辅助疗法 (TNT) 的好处和建议.
- 突出TNT在改善高风险直肠癌患者治疗结果中的作用.
- 讨论TNT后器官保存策略的新兴作用.
主要方法:
- 随机试验的综述和更新的S3指导方针关于整体新辅助治疗直肠癌.
- 对治疗反应和生存数据的分析,将TNT与传统的新辅助化学放射治疗进行比较.
- 包括磁共振成像 (MRI) 标准用于识别高风险患者.
主要成果:
- TNT显著改善瘤反应 (临床和病理完全缓解).
- 与标准的新辅助化学辐射疗法加手术相比,TNT显示出无疾病生存率的显著改善.
- 更新的指导方针建议TNT,特别是在MRI定义的高风险直肠癌 (例如cT4,cN2,mrCRM+,EMVI+) 中.
结论:
- 总的新辅助疗法是直肠癌的推治疗强化,改善了生存结果.
- 对于通过MRI识别的高风险患者来说,TNT特别有益.
- 在TNT后的完全临床缓解导致对器官保存 (观察和等待) 策略的兴趣增加.
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