Combined Modality Therapy for Rectal Cancer

被引:6
|
作者
Patel, Sagar A. [1 ]
Ryan, David P. [2 ]
Hong, Theodore S. [3 ]
机构
[1] Harvard Med Sch, Harvard Radiat Oncol Program, Massachusetts Gen Hosp, Boston, MA 02114 USA
[2] Harvard Med Sch, Div Hematol & Oncol, Massachusetts Gen Hosp, Boston, MA 02114 USA
[3] Harvard Med Sch, Dept Radiat Oncol, Massachusetts Gen Hosp, Boston, MA 02114 USA
来源
CANCER JOURNAL | 2016年 / 22卷 / 03期
关键词
Preoperative chemoradiation; postoperative chemotherapy; primary therapy; rectal cancer; surgery; CIRCUMFERENTIAL MARGIN INVOLVEMENT; TOTAL MESORECTAL EXCISION; SHORT-COURSE RADIOTHERAPY; PHASE-III TRIAL; RADIATION-THERAPY; LOCAL EXCISION; PREOPERATIVE RADIOTHERAPY; POSTOPERATIVE CHEMORADIOTHERAPY; ADJUVANT CHEMOTHERAPY; RANDOMIZED-TRIAL;
D O I
10.1097/PPO.0000000000000193
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The primary therapy for any potentially curative rectal cancer is surgery. For locally advanced tumors (i.e., T3-4 and/or node positive), the very high rate of local and distant recurrences has necessitated a standard adjuvant regimen of preoperative chemoradiation and postoperative chemotherapy. Several controversies regarding this approach remain, including the technique and fractionation scheme of radiation therapy prior to surgery, the choice of concomitant chemotherapy, and whether all patients require postoperative systemic therapy. Furthermore, in an era of improving staging imaging and surgical techniques, an opportunity for deescalation of therapy to improve patient morbidity and quality of life may arise. At the same time, advances in radiation and systemic therapy may help facilitate less invasive, sphincter-preserving surgery. This review addresses these questions and others that remain areas of active clinical investigation.
引用
收藏
页码:211 / 217
页数:7
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