Contemporary management of locally advanced rectal cancer:Resolving issues, controversies and shifting paradigms

作     者：Aeris Jane D.Nacion Youn Young Park Nam Kyu Kim 

作者机构：Department of Surgery Eastern Visayas Regional Medical Center Division of Colorectal Surgery Department of Surgery Yonsei University College of Medicine 

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

年 卷 期：2018年第30卷第1期

页      面：131-146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] 

主　　题：Locally advanced rectal cancer neoadjuvant treatment chemoradiotherapy 

摘      要：Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy（CRT） followed by total mesorectal excision（TME） reaches a plateau, the need for alternative strategies in locally advanced rectal cancer（LARC） has grown in relevance. Several novel strategies have been conceptualized to address this issue, including： 1） neoadjuvant induction and consolidation chemotherapy before CRT; 2） neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3） nonoperative management for patients who achieved pathological or clinical complete response after CRT. This article explores the issues, recent advances and paradigm shifts in the management of LARC and emphasizes the need for a personalized treatment plan for each patient based on tumor stage, location, gene expression and quality of life.