整体新辅助治疗直肠癌:为什么日本说"还没有"
Kay Uehara1, Akihisa Matsuda1, Takeshi Yamada1
1Department of Gastroenterological Surgery Nippon Medical School Tokyo Japan.
Annals of gastroenterological surgery
|March 9, 2026
概括
全新辅助疗法 (TNT) 是直肠癌的全球标准,改善了结果,并使非手术治疗成为可能. 日本 日本 日本 日本 日本.
科学领域:
- 胃肠道学和瘤学
- 手术瘤学手术瘤学
- 临床实践指南 临床实践指南
背景情况:
- 全新辅助疗法 (TNT) 在全球范围内越来越多地用于局部晚期直肠癌 (LARC).
- TNT显示了病理完整反应 (pCR) 率的提高,系统控制的增强,以及扩大非手术性管理 (NOM) 选项.
- 现在主要的国际指导方针将TNT纳入作为II/III期直肠癌的核心策略.
研究的目的:
- 为了研究LARC的TNT的全球采用情况.
- 在2024年指南中分析日本对TNT和NOM的不同立场.
- 探索影响TNT实施的障碍和上下文因素.
主要方法:
- 对支持TNT的关键III期临床试验的审查.
- 对国际和日本结直肠癌治疗指南的分析.
- 检查日本的医疗保健系统结构和实际挑战.
主要成果:
- 全球趋势有利于TNT,得到了强大的试验数据的支持.
- 日本的指导方针谨慎地建议不采用常规的TNT/NOM,反映了系统特定的挑战.
- 障碍包括非专业治疗中心,外科医生经验和未解决的毒性/生存数据.
结论:
- 日本的做法强调了需要将TNT适应当地医疗保健现实.
- 全面的TNT应用可能不是最佳的;定制的整合至关重要.
- 在未来的TNT策略中,平衡瘤疗效与以患者为中心的护理和当地环境是关键.
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