Advances in the prediction of the efficacy and sensitivity of neoadjuvant chemoradiotherapy in rectal cancer / 中华胃肠外科杂志

ABSTRACT

Rectal cancer has become one of the most common malignant tumors in our country. The treatment of total mesorectal excision after neoadjuvant chemoradiotherapy (NCRT) has become a standard treatment mode for locally advanced rectal cancer. However, the response of patients with rectal cancer to neoadjuvant chemotherapy varies, and treating all patients with NCRT may be suboptimal. Accurately predicting the efficacy and sensitivity of NCRT can help adjust treatment plan timely and avoid delay of condition in patients who are insensitive to NCRT. Existing research has confirmed that TNM staging, tumor regression grade and tumor markers and other clinical indicators can effectively predict the efficacy and sensitivity of NCRT, all kinds of clinical guidelines also recommend the three as a routine examination of patients with rectal cancer during NCRT. However, with the proposal of the concept of "Precise Medicine", the above clinical indexes cannot meet the clinical need of accurate treatment of rectal cancer. In recent years, with the accumulating studies on tumor immunotherapy, researchers have found that the sensitivity of NCRT is not only related to tumor biological characteristics, but also closely related to tumor microenvironment. Based on the current research, the indicators of tumor microenvironment, such as lymphocyte subsets count, neutrophil-lymphocyte ratio and programmed cell death ligand 1, have great potential clinical value in predicting the efficacy and sensitivity of rectal cancer. Further research based on relevant indicators of tumor microenvironment will enable accurate prediction of NCRT efficacy and sensitivity of NCRT and has important clinical significance for the realization of accurate and individualized treatment of rectal cancer.