直肠癌多学科综合治疗进展  

Advances in Multidisciplinary Treatment for Rectal Carcinoma

作　　者：赵长林[1] 唐磊[1] 殷江霞[1] 徐惠绵[2] 

机构地区：[1]大连大学附属新华医院肿瘤科大连大学肿瘤研究所,辽宁省大连市116021 [2]中国医科大学第一附属医院肿瘤科

出　　处：《中国肿瘤临床》2009年第12期715-719,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:总结直肠癌多学科综合治疗的最新进展,并对存在的问题和发展前景进行分析。方法:应用计算机检索Medline及CHKD期刊全文数据库检索系统,以"直肠癌/外科手术/化疗,放疗/分析"为关键词,检索2000年1月～2008年12月有关直肠癌多学科综合治疗及其价值方面的文献。精选30篇文献,最后纳入分析26篇。结果:准确的分期是直肠癌多学科综合治疗的关键,新辅助治疗结合根治性手术的模式是降低局部复发率、延长生存时间的有效手段,尤其在提高保肛率方面更具优势。根治性手术结合辅助治疗仍被公认为Ⅱ～Ⅲ期直肠癌的标准治疗模式。把握转移瘤可切除标准和时机结合辅助治疗可延长生存时间。化学新药和靶向药物及新联合治疗方案的引入,可提高直肠癌的疗效。结论:应积极倡导直肠癌规范化多学科综合治疗,与结肠癌相比,直肠癌多学科综合治疗改善总生存率的循证医学证据尚不充分,需深入研究。Objective： To summarize the advances in multidisciplinary treatment for rectal cancer, to analyze present difficulties in treating rectal cancer and to examine treatment prospects. Methods： The full text database retrieval system of Medline and the periodical of CHKD were searched using the key words ＂rectal cancer, diagnosis, surgery, chemotherapy, radiotherapy, targeted therapy, analysis＂ to retrieve journal articles related to the value and clinical significance of multidisciplinary treatment of rectal cancer. A total of 30 papers published between January 2000 and December 2008 were selected and 26 of them were used in this study. Results： Accurate preoperative staging of rectal cancer was the key factor for successful multidisciplinary and comprehensive treatment. Adjuvant therapy combined with radical surgery reduced the local recurrence rate, prolonged patient survival, and enhanced the sphincter preserving rate. Radical surgery combined with adjuvant therapy was considered the standard treatment for stage Ⅱ-Ⅲ rectal carcinoma. Following specific guidelines for tumor resection and the timing of resection was helpful for prolonging patient survival. Newly formulated chemical drugs and targeted drugs should improve the efficacy of surgery for rectal cancer. Conclusion： Multidisciplinary and comprehensive treatment for rectal cancer should be advocated. The effect of such treatment on the overall survival of rectal cancer patients has not been as well studied as it has been in colon cancer patients, and further study is needed to elucidate this issue.

关 键 词：直肠癌 外科手术 化学治疗 放射治疗 分析 

分 类 号：R735.37[医药卫生—肿瘤]