基于循证医学的结肠癌新辅助化疗

随着生活水平的提高,结直肠癌处于高发状态,是致死率较高的肿瘤之一.目前,手术仍然是治疗结肠癌的首选方式.而逐渐兴起的新辅助化疗使得手术成功率有所提升并显著提升了术后生存率.除了传统的化疗药物如氟尿嘧啶、奥沙利铂等,分子靶向药物显示出了较高的反应率并在延长疾病复发时间方面显示出了强大的作用.但新辅助化疗的一些不良反应如化疗期间原有病灶进展、出血及肝损伤等问题,也需要注意.此外对于应用新辅助化疗的指征及使用的时间也没有达成共识.未来,在一些大型RCT实验的基础上,这些争议有望得以解决。

Neoadjuvant chemotherapy for colon cancer based on evidence-based medicine

The incidence of colon cancer has been increasing in recent years with the improvement in living standard,and becomes one of the leading causes of cancerrelated death.While radical surgery remains the primary choice for colon cancer,neoadjuvant chemotherapy has significantly improved the successful rate of surgery and increased postoperative survival.In addition to traditional chemotherapy with 5-Fu or oxliplatin,molecular targeted drugs lead to a higher response rate and show its dramatic effect on diseaserecurrence time.However some side effects such as disease progression during chemotherapy,bleeding or liver toxicity should be concerned.In addition,indications for neoadjuvant chemotherapy do not reach a consensus.In the future,these controversies may be solved based on some large randomized controlled trials.