局部晚期直肠癌新辅助放化疗联合PD-1/PD-L1抑制剂的研究进展  

Immunotherapy in the neoadjuvant chemoradiotherapy for locally advanced rectal cancer

作　　者：李昊岳 金晶 Li Haoyue;Jin Jing(Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen 518116,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科,北京100021 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院放疗科,深圳518116

出　　处：《中华放射肿瘤学杂志》2023年第8期725-730,共6页Chinese Journal of Radiation Oncology

摘　　要：术前长程同步放化疗或短程放疗后即刻手术联合术后化疗是目前局部晚期直肠癌(LARC)主要的标准治疗之一。在此基础上的全程新辅助治疗(TNT)可改善无瘤生存、无远处转移生存并提高肿瘤完全缓解率, 但3年的远处转移风险仍高于20%, 病理完全缓解率不足30%, LARC的长期生存及不良反应有待改善。目前, 免疫治疗已在多个癌种取得巨大成果, 将免疫治疗引入直肠癌领域亟待研究。针对LARC近年出现多项免疫治疗联合术前放化疗的临床试验, 同时也有不少免疫治疗结直肠癌的研究, 其中免疫治疗多以程序性死亡蛋白-1(PD-1)/程序性死亡蛋白配体-1(PD-L1)抑制剂为代表, 本文就上述研究进行综述。Long-course concurrent chemoradiotherapy(CCRT)or short-course radiotherapy(SCRT)prior to surgery and postoperative chemotherapy is one of the main standard therapies for patients with locally advanced rectal cancer(LARC).On this basis,total neoadjuvant therapy(TNT)has been shown to improve disease-free survival,distant metastasis-free survival and complete response rates,whereas the 3-year distant recurrence rate is still above 20%and pathological complete response(pCR)is less than 30%.Long-term survival and adverse reactions remain to be improved.Currently,significant achivement has been obtained in immunotherapy.Application of immunotherapy in the treatment of rectal cancer remains to be urgently validated.In recent years,immunotherapy combined with preoperative chemoradiotherapy has been adopted for LARC in clinical trials.Besides,immunotherapy alone,especially programmed death-1(PD-1)/programmed death ligand-1(PD-L1)inhibitor,has also been utilized to treat colon rectal cancer.Relevant research progress was reviewed in this article.

关 键 词：直肠肿瘤 局部晚期 放射免疫疗法 放化疗 免疫检查点抑制剂 研究进展 

分 类 号：R735.37[医药卫生—肿瘤]