Locally advanced rectal cancer: Current and future perioperative treatment strategies

被引:0
|
作者
Hofheinz, Ralf-Dieter [1 ]
机构
[1] Heidelberg Univ, Univ Med Mannheim, Interdisziplinaren Tumorzentrum Mannheim, TagesTherapieZentrum, Theodor Kutzer Ufer 1-3,Haus 9, D-68167 Mannheim, Germany
来源
ONKOLOGE | 2020年 / 26卷 / 12期
关键词
Neoplasm metastasis; Neoadjuvant therapy; Oxaliplatin; Chemoradiotherapy; Local neoplasm recurrence; ADJUVANT CHEMOTHERAPY; OPEN-LABEL; PREOPERATIVE CHEMORADIOTHERAPY; NEOADJUVANT CHEMORADIOTHERAPY; OXALIPLATIN; MULTICENTER; FLUOROURACIL; TRIAL; CHEMORADIATION; LEUCOVORIN;
D O I
10.1007/s00761-020-00843-1
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Strategies in the perioperative treatment of locally advanced rectal cancer are currently changing significantly. Results The "one-treatment-fits-all" approach of neoadjuvant radio(chemo)therapy followed by surgery and optional adjuvant therapy is increasingly being abandoned in favor of prolonged neoadjuvant chemotherapy in the sense of the so-called total neoadjuvant therapy (TNT), omission of radiotherapy for patients at low risk of local recurrence or a watch-and-wait strategy or organ preservation in case of complete clinical remission after radiochemotherapy. Conclusion The primary focus of this article is to describe the current state of the art and discuss the TNT strategy and the omission of radiotherapy on the basis of current data. In accordance with the guidelines, neoadjuvant radio(chemo)therapy can be omitted in patients with rectal cancer in which a quality-assured MRI shows a low risk for local recurrence and immediate total mesorectal excision surgery is indicated.
引用
收藏
页码:1142 / 1153
页数:12
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