Inquire into optimizing neoadjuvant therapy for rectal cancer / 国际外科学杂志

ABSTRACT

Locally advanced rectal cancer has historically been considered as a challenge in colorectal surgery. Preoperative neoadjuvant chemoradiotherapy combined with total mesorectal excision is the current standard mode. However, there are differences between domestic and foreign guidelines for patients with different stages. Neoadjuvant treatment of locally advanced rectal cancer has improved local control and enhanced sphincter preservation but has not improved overall survival. In addition, neoadjuvant therapy also brings related complications and affects the quality of life of patients. Stratified treatment according to accurate staging of rectal MRI is the focus of current clinical research. For low-intermediate risk patients, surgery alone or neoadjuvant chemotherapy combined with selective radiotherapy will hopefully lead to a more personalized treatment of rectal cancer. For high risk patients, total neoadjuvant therapy mode enhances the intensity of neoadjuvant chemotherapy, which may prevent distant failure and benefit overall survival. The role of immunotherapy in neoadjuvant treatment of rectal cancer has achieved exciting short-term results, while the long-term efficacy needs to be further confirmed. This article will describe the revelant strategies for optimizing the neoadjuvant treatment mode of rectal cancer based on the existing evidence.