Adjuvant chemotherapy for rectal cancer:Is it needed?

作     者：Kristijonas Milinis Michael Thornton Amir Montazeri Paul S Rooney 

作者机构：Faculty of MedicineUniversity of Liverpool Department of Colorectal Surgerythe Royal Liverpool University Hospital Department of Oncologythe Clatterbridge Cancer Centre NHS Foundation Trust 

出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)

年 卷 期：2015年第6卷第6期

页      面：225-236页

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

主　　题：Rectal cancer Adjuvant chemotherapy 

摘      要：Adjuvant chemotherapy has become a standard treatment of advanced rectal cancer in the West. The benefits of adjuvant chemotherapy after surgery alone have been well established. However,controversy surrounds the use adjuvant chemotherapy in patients who received preoperative chemoradiotherapy,despite it being recommended by a number of international guidelines. Results of recent multicentre randomised control trials showed no benefit of adjuvant chemotherapy in terms of survival and rates of distant metastases. However,concerns exist regarding the quality of the studies including inadequate staging modalities,out-dated chemotherapeutic regimens and surgical approaches and small sample sizes. It has become evident that not all the patients respond to adjuvant chemotherapy and more personalised approach should be employed when considering the benefits of adjuvant chemotherapy. The present review discusses the strengths and weaknesses of the current evidence-base and suggests improvements for future studies.