新辅助放化疗联合免疫治疗局部进展期直肠癌的突破与挑战  

Breakthroughs and challenges in neoadjuvant chemoradiotherapy combined with immunotherapy for locally advanced rectal cancer

作　　者：王乾宇 杜峻峰 李世拥 Wang Qianyu;Du Junfeng;LiShiyong(Medical Department of General Surgery,The First Medical Center,Chinese PLA General Hospital,Beijing,100853,China;Department of General Surgery,The Seventh Medical Center,Chinese PLA General Hospital,Beijing,100700,China;Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing,100730,China)

机构地区：[1]中国人民解放军总医院第一医学中心普通外科医学部,北京100853 [2]中国人民解放军总医院第七医学中心普通外科,北京100700 [3]中国医学科学院北京协和医院基本外科,北京100730

出　　处：《中华普外科手术学杂志(电子版)》2025年第2期128-131,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：北京市自然科学基金(7242034)。

摘　　要：尽管新辅助放化疗已成为局部进展期直肠癌(LARC)的标准治疗方案,但其疗效和长期生存率仍有待进一步提高。随着免疫治疗的快速发展,尤其是免疫检查点抑制剂(ICI)的应用,为LARC的治疗带来了新的希望。研究表明,新辅助放化疗联合免疫治疗能够提高LARC患者的完全缓解率,并且表现出良好的安全性。然而,这种新型治疗模式在临床实践中仍面临诸多挑战,包括有效生物标志物的识别、克服免疫耐药性以及优化给药方案等问题。本文评述了新辅助放化疗联合免疫治疗在LARC中的突破及面临的挑战,并探讨了未来可能的优化方向,以期为LARC患者提供更加有效的治疗选择。Although neoadjuvant chemoradiotherapy has become the standard treatment for locally advanced rectal cancer(LARC),its efficacy and long-term survival rates still need improvement.The rapid development of immunotherapy,particularly the use of immune checkpoint inhibitors(ICIs),has brought new hope to the treatment of LARC.Studies indicate that combining neoadjuvant chemoradiotherapy with immunotherapy can increase the complete response rate in LARC patients and demonstrates good safety profiles.However,this novel treatment approach faces several challenges in clinical practice,including the identification of effective biomarkers,overcoming immune resistance,and optimizing treatment regimens.This review discusses the breakthroughs and challenges of neoadjuvant chemoradiotherapy combined with immunotherapy in LARC and explores potential future directions for optimization,aiming to provide more effective treatment options for LARC patients..

关 键 词：局部进展期直肠癌 新辅助放化疗 新辅助免疫治疗 

分 类 号：R73[医药卫生—肿瘤]