Advances of optimized neoadjuvant therapy in the treatment of locally advanced rectal cancer

• Published in: Zhonghua wei chang wai ke za zhi Vol. 22; no. 6; p. 527
• Main Authors: Fan, J, Zhu, J
• Format: Journal Article
• Language: Chinese
• Published: China 25.06.2019
• Subjects: Non-surgical treatment; Rectal neoplasms; Neoadjuvant chemoradiotherapy; Total neoadjuvant therapy
• ISSN: 1671-0274
• DOI: 10.3760/cma.j.issn.1671-0274.2019.06.005

Neoadjuvant chemoradiotherapy is the current standard of care for locally advanced rectal cancer. However, this modality is facing more and more challenges. The research progress on this issue around the world can be summarized into three aspects. The first is to increase the intensity of treatment to obtain better tumor regression, such as adding a second drug during the neoadjuvant chemoradiotherapy, prolonging the interval and receiving sufficient chemotherapy before surgery. Current research data are not sufficient to support strategies for adding drugs or receiving sufficient chemotherapy before surgery, but it may be worth looking forward to adding irinotecan during neoadjuvant chemoradiotherapy, and an appropriate extension of the interval before surgery may also be a good option. Secondly, we can reduce the intensity of treatment to improve the quality of life of patients with a non-inferior clinical outcome, such as non-surgical approach, local excision rather than total mesorectal excision and remov