Recent advances in multidisciplinary approach for rectal cancer

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• 作者：Eiji Oki ; Koji Ando ; Yuta Kasagi ; Yoko Zaitsu…
• 关键词：Rectal cancer ; Neoadjuvant chemoradiotherapy ; Total mesorectal excision ; Adjuvant chemotherapy
• 刊名：International Journal of Clinical Oncology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：20
• 期：4
• 页码：641-649
• 全文大小：438 KB
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• 作者单位：Eiji Oki (1)
  Koji Ando (1)
  Yuta Kasagi (1)
  Yoko Zaitsu (1)
  Masahiko Sugiyama (1)
  Yuichiro Nakashima (1)
  Hideto Sonoda (1)
  Kippei Ohgaki (1)
  Hiroshi Saeki (1)
  Yoshihiko Maehara (1)
  
  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Surgical Oncology
  Radiotherapy
  Diagnostic Radiology
  Internal Medicine
  Pathology
  
• 出版者：Springer Japan
• ISSN：1437-7772

文摘

Surgery is a major treatment option for rectal cancer, and total mesorectal excision has been demonstrated to be advantageous in terms of oncological outcome and thus has been the standard surgical approach. Radiotherapy before or after radical surgery is the optimal treatment to control local recurrence of advanced rectal cancer. To date, in many countries, the combination of neoadjuvant concurrent chemotherapy and radiotherapy is considered the standard therapy. A more recent interest in neoadjuvant therapy has been the use of oxaliplatin or targeted agents for neoadjuvant chemoradiotherapy. However, despite many trials of oxaliplatin and targeted agents, 5-FU-based concurrent chemoradiotherapy has remained the only standard treatment option. Postoperative adjuvant chemotherapy with neoadjuvant chemoradiotherapy or induction chemotherapy with neoadjuvant chemoradiotherapy may further improve patient survival, as some clinical studies recently indicated. In Japan, neoadjuvant therapy is not the standard treatment method, because surgery with lateral lymph node dissection is usually performed and this type of surgery may reduce recurrence rate as does radiation therapy. The phase III study to evaluate the oncological effect of the Japanese standard operation (mesorectal excision, ME) with lateral lymph node dissection in comparison with ME alone for clinical stage II and III lower rectal cancer is currently ongoing.