局部复发性直肠癌的治疗进展

局部复发性直肠癌(locally recurrent rectal cancer,LRRC)的治疗是多学科综合治疗,包括手术、外放疗、术中放疗、放射性粒子植入治疗、热疗和射频消融治疗等,目前仍以手术和放疗为主。肿瘤完全切除(R0切除)是影响预后的独立因素。随着调强放疗(intensity modulated radiation therapy,IMRT)和立体定向放疗(stereotactic body radiotherapy,SBRT)的出现,既往接受过放疗的患者行再程放疗的疗效被肯定,不良反应在可接受的范围内。此外,随着更多治疗方式的出现,患者的生存率和局部控制率均得到提高,生存质量也得到改善。LRRC的治疗需要多学科医师的共同参与,如何选择适当有效的治疗仍需要更多的研究进行证实。本文就近年来LRRC的综合治疗进展及仍待解决的问题进行综述。

Progress in the treatment of locally recurrent rectal cancer

The treatment of locally recurrent rectal cancer (LRRC) is multidisciplinary, including surgery, external beam radiotherapy, intraoperative radiotherapy, radioactive seed implantation, hyperthermia therapy, radiofrequency ablation, etc. Nevertheless, the predominant treatments are surgery and radiotherapy. Complete resection (R0 resection) is an independent prognostic factor. With the advent of intensity modulated radiation therapy (IMRT) and stereotactic body radiotherapy (SBRT), the efficacy of re-irradiation for patients who have previously received radiotherapy is confirmed, and the side effects are acceptable. Moreover, with the development of more treatment modalities, the survival rate and local control rate of patients are increasing, and the quality of life is improved. In conclusion, the treatment of LRRC is comprehensive and requires the participation of multidisciplinary physicians. However, proper and effective treatment needs more research evidence. This review summarized the latest progress in the multidisciplinary treatment of LRRC and the unresolved problems.