Nonoperative management of gastrointestinal malignancies in era of neoadjuvant treatment

作     者：Nan Chen Jaffer A Ajani Aiwen Wu Nan Chen;Jaffer A Ajani;Aiwen Wu

作者机构：Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Bejing)Gastrointestinal Cancer CenterPeking University Cancer Hospital&InstituteBeijing 100142China Department of Gastrointestinal Medical OncologyThe University of Texas MD Anderson Cancer CenterHouston 77030USA 

出 版 物：《Chinese Journal of Cancer Research》 (中国癌症研究（英文版）)

年 卷 期：2023年第35卷第1期

页      面：44-57页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：National Natural Science Foundation(No.81773214) Beijing Municipal Administration of Hospital Medicine Development of Special Funding Support(No.ZYLX202116) Beijing Municipal Administration of Hospitals Incubating Program(No.PZ2020027) Beijing Talent Incubating Funding(No.2019-4) Science Foundation of Peking University Cancer Hospital(No.2023-10) 

主　　题：Nonoperative management gastrointestinal malignancies neoadjuvant treatment 

摘      要：Cancers derived from the gastrointestinal(GI)tract are often treated with radical surgery to achieve a ***,recent advances in the management of GI cancers involve the use of a combination of neoadjuvant radiation and chemotherapy followed by surgical intervention to achieve improved local control and ***,a small proportion of patients with highly sensitive tumors achieved a pathological complete response(pCR)(no residual tumor cells in the resected specimen)to neoadjuvant chemoradiation therapy(nCRT).The desire for organ preservation and avoidance of surgical morbidity brings the idea of a nonoperative management(NOM)*** of the different nature of tumor biology,GI cancers present diverse responses to nCRT,ranging from high sensitivity(anal cancer)to low sensitivity(gastric/esophageal cancer).There is an increasing attention to NOM of localized GI cancers;however,without the use of biomarkers/imaging parameters to select such patients,NOM will remain a ***,this review intends to summarize some of the recent updates from the aspect of current nCRT regimens,criteria for patient selection and active surveillance *** also hope to review significant sequelae of radical surgery and the complications of nCRT to clarify the directions for optimization of nCRT and NOM for oncologic outcomes and quality of life.