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Article(id=1199337301408052223, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1199337298941804946, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2369.2023.0619, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1667923200000, receivedDateStr=2022-11-09, revisedDate=null, revisedDateStr=null, acceptedDate=1680710400000, acceptedDateStr=2023-04-06, onlineDate=1763873895265, onlineDateStr=2025-11-23, pubDate=1706371200000, pubDateStr=2024-01-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763873895265, onlineIssueDateStr=2025-11-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763873895265, creator=13701087609, updateTime=1763873895265, updator=13701087609, issue=Issue{id=1199337298941804946, tenantId=1146029695717560320, journalId=1189873630562394117, year='2024', volume='49', issue='1', pageStart='1', pageEnd='120', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1763873894677, creator=13701087609, updateTime=1763874094669, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1199338137823572576, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1199337298941804946, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1199338137823572577, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1199337298941804946, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=17, endPage=22, ext={EN=ArticleExt(id=1199337301714235397, articleId=1199337301408052223, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Total neoadjuvant therapy for locally advanced rectal cancer, columnId=1199337300007158168, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Special Issue on Rectal Cancer Surgery and Perioperative Treatment Strategies, runingTitle=null, highlight=null, articleAbstract=

Diagnosis and treatment of locally advanced rectal cancer (LARC) must be completed by a collaborative model of a multi-disciplinary team. The neoadjuvant chemoradiotherapy significantly reduced the local recurrence rate of LARC, but did not affect the occurrence of distant metastases and overall survival. Total neoadjuvant therapy (TNT), by strengthening the intensity of chemotherapy and extending the time from radiotherapy to surgery, can improve the tumor response rate as well as disease-free survival rate and metastasis-free survival rate. It offers advantages such as enhancing the compliance with chemotherapy, maximizing tumor regression, improving survival and increasing the chance of organ preservation. TNT is a promising treatment model for LARC patients with high risk of distant metastasis or strong desire for organ preservation. With the application of immunotherapy in the field of TNT, the mode of TNT continues to expand. And the exploration of therapeutic predictive markers will help to provide a personalized treatment for patients.

, correspAuthors=Hai-Yan Chen, authorNote=null, correspAuthorsNote=
E-mail:
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局部进展期直肠癌(LARC)目前公认的治疗模式为多学科综合治疗。标准术前同步放化疗可明显降低LARC的局部复发率，但不影响其远处转移发生率和总生存率，而全程新辅助治疗(TNT)通过提高化疗强度、延长放疗至手术的时间，从而提高肿瘤缓解率，可明显改善无病生存率和无转移生存率。TNT模式可明显提高患者的依从性，使全身化疗完成度更高，能带来最大程度的肿瘤退缩，不但能改善远期生存，也能增加器官功能保留的机会。对于远处转移风险高或器官功能保留意愿强的LARC患者，TNT是一种极具潜力的治疗模式。随着免疫治疗在TNT领域的应用，TNT模式不断拓展；同时，疗效预测标志物的探索将为个体化治疗奠定基础。

, correspAuthors=陈海燕, authorNote=null, correspAuthorsNote=
陈海燕，E-mail：
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周荻，硕士研究生，主治医师，主要从事腹盆腔恶性肿瘤的放疗及综合治疗研究

陈海燕，医学博士，副主任医师，上海市医学会放疗专业委员会青年委员，中国研究型医院学会放射肿瘤学专业委员会委员，中国抗癌协会小儿肿瘤专业委员会放疗学组委员。目前承担医工交叉青年项目及国家自然科学基金青年项目等多项课题。

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周荻，硕士研究生，主治医师，主要从事腹盆腔恶性肿瘤的放疗及综合治疗研究

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周荻，硕士研究生，主治医师，主要从事腹盆腔恶性肿瘤的放疗及综合治疗研究

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陈海燕，医学博士，副主任医师，上海市医学会放疗专业委员会青年委员，中国研究型医院学会放射肿瘤学专业委员会委员，中国抗癌协会小儿肿瘤专业委员会放疗学组委员。目前承担医工交叉青年项目及国家自然科学基金青年项目等多项课题。

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陈海燕，医学博士，副主任医师，上海市医学会放疗专业委员会青年委员，中国研究型医院学会放射肿瘤学专业委员会委员，中国抗癌协会小儿肿瘤专业委员会放疗学组委员。目前承担医工交叉青年项目及国家自然科学基金青年项目等多项课题。

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Fluorouracil-based adjuvant chemotherapy after preoperative chemoradiotherapy in rectal cancer: long-term results of the EORTC 22921 randomised study, refAbstract=null), Reference(id=1199376213123887338, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2014, volume=113, issue=2, pageStart=223, pageEnd=229, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=Sainato A, Cernusco Luna Nunzia V, Valentini V, journalName=Radiother Oncol, refType=null, unstructuredReference=Sainato A, Cernusco Luna Nunzia V, Valentini V, et al. No benefit of adjuvant fluorouracil leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): long term results of a randomized trial (I-CNR-RT)[J]. Radiother Oncol, 2014, 113(2): 223-229., articleTitle=No benefit of adjuvant fluorouracil leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): long term results of a randomized trial (I-CNR-RT), refAbstract=null), Reference(id=1199376213245522160, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2006, volume=24, issue=4, pageStart=668, pageEnd=674, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=Chau I, Brown G, Cunningham D, journalName=J Clin Oncol, refType=null, unstructuredReference=Chau I, Brown G, Cunningham D, et al. Neoadjuvant capecitabine and oxaliplatin followed by synchronous chemoradiation and total mesorectal excision in magnetic resonance imaging-defined poor-risk rectal cancer[J]. J Clin Oncol, 2006, 24(4): 668-674., articleTitle=Neoadjuvant capecitabine and oxaliplatin followed by synchronous chemoradiation and total mesorectal excision in magnetic resonance imaging-defined poor-risk rectal cancer, refAbstract=null), Reference(id=1199376213350379764, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2022, volume=39, issue=6, pageStart=519, pageEnd=522, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=吴胜伟, 吴晓翔, 王志伟, journalName=新乡医学院学报, refType=null, unstructuredReference=吴胜伟, 吴晓翔, 王志伟. 保留盆腔自主神经的腹腔镜全直肠系膜切除术对女性直肠癌患者术后复发及排尿和性生活质量的影响[J]. 新乡医学院学报, 2022, 39(6): 519-522., articleTitle=保留盆腔自主神经的腹腔镜全直肠系膜切除术对女性直肠癌患者术后复发及排尿和性生活质量的影响, refAbstract=null), Reference(id=1199376213459431673, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2019, volume=30, issue=8, pageStart=1298, pageEnd=1303, url=null, language=null, rfNumber=[6], rfOrder=5, authorNames=Ciseł B, Pietrzak L, Michalski W, journalName=Ann Oncol, refType=null, unstructuredReference=Ciseł B, Pietrzak L, Michalski W, et al. Long-course preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for clinical T4 and fixed clinical T3 rectal cancer: long-term results of the randomized Polish Ⅱ study[J]. Ann Oncol, 2019, 30(8): 1298-1303., articleTitle=Long-course preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for clinical T4 and fixed clinical T3 rectal cancer: long-term results of the randomized Polish Ⅱ study, refAbstract=null), Reference(id=1199376213555900669, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2021, volume=22, issue=1, pageStart=29, pageEnd=42, url=null, language=null, rfNumber=[7], rfOrder=6, authorNames=Bahadoer RR, Dijkstra EA, van Etten B, journalName=Lancet Oncol, refType=null, unstructuredReference=Bahadoer RR, Dijkstra EA, van Etten B, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial[J]. Lancet Oncol, 2021, 22(1): 29-42., articleTitle=Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial, refAbstract=null), Reference(id=1199376213690118399, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2022, volume=40, issue=15, pageStart=1681, pageEnd=1692, url=null, language=null, rfNumber=[8], rfOrder=7, authorNames=Jin J, Tang Y, Hu C, journalName=J Clin Oncol, refType=null, unstructuredReference=Jin J, Tang Y, Hu C, et al. Multicenter, randomized, phase Ⅲ trial of short-term radiotherapy plus chemotherapy versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR)[J]. J Clin Oncol, 2022, 40(15): 1681-1692., articleTitle=Multicenter, randomized, phase Ⅲ trial of short-term radiotherapy plus chemotherapy versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR), refAbstract=null), Reference(id=1199376213774004481, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2020, volume=38, issue=null, pageStart=4007, pageEnd=null, url=null, language=null, rfNumber=[9], rfOrder=8, authorNames=Conroy T, Lamfichekh N, Etienne PL, journalName=J Clin Oncol, refType=null, unstructuredReference=Conroy T, Lamfichekh N, Etienne PL, et al. Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiation in patients with locally advanced rectal cancer: final results of PRODIGE 23 phase Ⅲ trial, a UNICANCER GI trial[J]. J Clin Oncol, 2020, 38(Suppl 15): 4007., articleTitle=Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiation in patients with locally advanced rectal cancer: final results of PRODIGE 23 phase Ⅲ trial, a UNICANCER GI trial, refAbstract=null), Reference(id=1199376213929193733, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2022, volume=40, issue=23, pageStart=2546, pageEnd=2556, url=null, language=null, rfNumber=[10], rfOrder=9, authorNames=Garcia-Aguilar J, Patil S, Gollub MJ, journalName=J Clin Oncol, refType=null, unstructuredReference=Garcia-Aguilar J, Patil S, Gollub MJ, et al. Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy[J]. J Clin Oncol, 2022, 40(23): 2546-2556., articleTitle=Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy, refAbstract=null), Reference(id=1199376214046634251, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2018, volume=16, issue=7, pageStart=874, pageEnd=901, url=null, language=null, rfNumber=[11], rfOrder=10, authorNames=Benson AB, Venook AP, Al-Hawary MM, journalName=J Natl Compr Canc Netw, refType=null, unstructuredReference=Benson AB, Venook AP, Al-Hawary MM, et al. Rectal Cancer, version 2.2018, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2018, 16(7): 874-901., articleTitle=Rectal Cancer, version 2.2018, NCCN clinical practice guidelines in oncology, refAbstract=null), Reference(id=1199376214159880465, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2021, volume=13, issue=2, pageStart=119, pageEnd=130, url=null, language=null, rfNumber=[12], rfOrder=11, authorNames=Tuta M, Boc N, Brecelj E, journalName=World J Gastrointest Oncol, refType=null, unstructuredReference=Tuta M, Boc N, Brecelj E, et al. Total neoadjuvant therapy vs standard therapy of locally advanced rectal cancer with high-risk factors for failure[J]. World J Gastrointest Oncol, 2021, 13(2): 119-130., articleTitle=Total neoadjuvant therapy vs standard therapy of locally advanced rectal cancer with high-risk factors for failure, refAbstract=null), Reference(id=1199376214247960853, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2015, volume=16, issue=8, pageStart=979, pageEnd=989, url=null, language=null, rfNumber=[13], rfOrder=12, authorNames=Rödel C, Graeven U, Fietkau R, journalName=Lancet Oncol, refType=null, unstructuredReference=Rödel C, Graeven U, Fietkau R, et al. Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial[J]. Lancet Oncol, 2015, 16(8): 979-989., articleTitle=Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial, refAbstract=null), Reference(id=1199376214336041241, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2019, volume=37, issue=34, pageStart=3223, pageEnd=3233, url=null, language=null, rfNumber=[14], rfOrder=13, authorNames=Deng Y, Chi P, Lan P, journalName=J Clin Oncol, refType=null, unstructuredReference=Deng Y, Chi P, Lan P, et al. Neoadjuvant modified FOLFOX6 with or without radiation versus fluorouracil plus radiation for locally advanced rectal cancer: final results of the Chinese FOWARC trial[J]. J Clin Oncol, 2019, 37(34): 3223-3233., articleTitle=Neoadjuvant modified FOLFOX6 with or without radiation versus fluorouracil plus radiation for locally advanced rectal cancer: final results of the Chinese FOWARC trial, refAbstract=null), Reference(id=1199376214432510238, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2021, volume=13, issue=23, pageStart=6035, pageEnd=null, url=null, language=null, rfNumber=[15], rfOrder=14, authorNames=Des Guetz G, Landre T, Bollet MA, journalName=Cancers (Basel), refType=null, unstructuredReference=Des Guetz G, Landre T, Bollet MA, et al. Is there a benefit of oxaliplatin in combination with neoadjuvant chemoradiotherapy for locally advanced rectal cancer? An updated meta-analysis[J]. Cancers (Basel), 2021, 13(23): 6035., articleTitle=Is there a benefit of oxaliplatin in combination with neoadjuvant chemoradiotherapy for locally advanced rectal cancer? An updated meta-analysis, refAbstract=null), Reference(id=1199376214520590629, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2020, volume=38, issue=36, pageStart=4231, pageEnd=4239, url=null, language=null, rfNumber=[16], rfOrder=15, authorNames=Zhu J, Liu A, Sun X, journalName=J Clin Oncol, refType=null, unstructuredReference=Zhu J, Liu A, Sun X, et al. Multicenter, randomized, phase Ⅲ trial of neoadjuvant chemoradiation with capecitabine and irinotecan guided by UGT1A1 status in patients with locally advanced rectal cancer[J]. J Clin Oncol, 2020, 38(36): 4231-4239., articleTitle=Multicenter, randomized, phase Ⅲ trial of neoadjuvant chemoradiation with capecitabine and irinotecan guided by UGT1A1 status in patients with locally advanced rectal cancer, refAbstract=null), Reference(id=1199376214617059623, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2008, volume=71, issue=4, pageStart=1181, pageEnd=1188, url=null, language=null, rfNumber=[17], rfOrder=16, authorNames=Habr-Gama A, Perez RO, Proscurshim I, journalName=Int J Radiat Oncol Biol Phys, refType=null, unstructuredReference=Habr-Gama A, Perez RO, Proscurshim I, et al. Interval between surgery and neoadjuvant chemoradiation therapy for distal rectal cancer: does delayed surgery have an impact on outcome?[J]. Int J Radiat Oncol Biol Phys, 2008, 71(4): 1181-1188., articleTitle=Interval between surgery and neoadjuvant chemoradiation therapy for distal rectal cancer: does delayed surgery have an impact on outcome?, refAbstract=null), Reference(id=1199376214717722923, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2009, volume=250, issue=4, pageStart=582, pageEnd=589, url=null, language=null, rfNumber=[18], rfOrder=17, authorNames=Kalady MF, de Campos-Lobato LF, Stocchi L, journalName=Ann Surg, refType=null, unstructuredReference=Kalady MF, de Campos-Lobato LF, Stocchi L, et al. Predictive factors of pathologic complete response after neoadjuvant chemoradiation for rectal cancer[J]. Ann Surg, 2009, 250(4): 582-589., articleTitle=Predictive factors of pathologic complete response after neoadjuvant chemoradiation for rectal cancer, refAbstract=null), Reference(id=1199376214805803313, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2006, volume=17, issue=7, pageStart=1103, pageEnd=1110, url=null, language=null, rfNumber=[19], rfOrder=18, authorNames=Calvo FA, Serrano FJ, Diaz-González JA, journalName=Ann Oncol, refType=null, unstructuredReference=Calvo FA, Serrano FJ, Diaz-González JA, et al. Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation[J]. Ann Oncol, 2006, 17(7): 1103-1110., articleTitle=Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation, refAbstract=null), Reference(id=1199376214902272309, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2015, volume=16, issue=8, pageStart=957, pageEnd=966, url=null, language=null, rfNumber=[20], rfOrder=19, authorNames=Garcia-Aguilar J, Chow OS, Smith DD, journalName=Lancet Oncol, refType=null, unstructuredReference=Garcia-Aguilar J, Chow OS, Smith DD, et al. Timing of rectal cancer response to chemoradiation consortium. Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial[J]. Lancet Oncol, 2015, 16(8): 957-966., articleTitle=Timing of rectal cancer response to chemoradiation consortium. Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial, refAbstract=null), Reference(id=1199376214969381177, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2018, volume=4, issue=6, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[21], rfOrder=20, authorNames=Cercek A, Roxburgh CSD, Strombom P, journalName=JAMA Oncol, refType=null, unstructuredReference=Cercek A, Roxburgh CSD, Strombom P, et al. Adoption of total neoadjuvant therapy for locally advanced rectal cancer[J]. JAMA Oncol, 2018, 4(6): e180071., articleTitle=Adoption of total neoadjuvant therapy for locally advanced rectal cancer, refAbstract=null), Reference(id=1199376215065850171, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2019, volume=135, issue=null, pageStart=178, pageEnd=186, url=null, language=null, rfNumber=[22], rfOrder=21, authorNames=Erlandsson J, Lörinc E, Ahlberg M, journalName=Radiother Oncol, refType=null, unstructuredReference=Erlandsson J, Lörinc E, Ahlberg M, et al. Tumour regression after radiotherapy for rectal cancer: results from the randomised Stockholm Ⅲ trial[J]. Radiother Oncol, 2019, 135: 178-186., articleTitle=Tumour regression after radiotherapy for rectal cancer: results from the randomised Stockholm Ⅲ trial, refAbstract=null), Reference(id=1199376215195873602, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2017, volume=24, issue=8, pageStart=2095, pageEnd=2103, url=null, language=null, rfNumber=[23], rfOrder=22, authorNames=Lorimer PD, Motz BM, Kirks RC, journalName=Ann Surg Oncol, refType=null, unstructuredReference=Lorimer PD, Motz BM, Kirks RC, et al. Pathologic complete response rates after neoadjuvant treatment in rectal cancer: an analysis of the National Cancer Database[J]. Ann Surg Oncol, 2017, 24(8): 2095-2103., articleTitle=Pathologic complete response rates after neoadjuvant treatment in rectal cancer: an analysis of the National Cancer Database, refAbstract=null), Reference(id=1199376215313314123, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2003, volume=46, issue=3, pageStart=298, pageEnd=304, url=null, language=null, rfNumber=[24], rfOrder=23, authorNames=García-Aguilar J, Hernandez de Anda E, Sirivongs P, journalName=Dis Colon Rectum, refType=null, unstructuredReference=García-Aguilar J, Hernandez de Anda E, Sirivongs P, et al. A pathologic complete response to preoperative chemoradiation is associated with lower local recurrence and improved survival in rectal cancer patients treated by mesorectal excision[J]. Dis Colon Rectum, 2003, 46(3): 298-304., articleTitle=A pathologic complete response to preoperative chemoradiation is associated with lower local recurrence and improved survival in rectal cancer patients treated by mesorectal excision, refAbstract=null), Reference(id=1199376215502057814, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2010, volume=11, issue=9, pageStart=835, pageEnd=844, url=null, language=null, rfNumber=[25], rfOrder=24, authorNames=Maas M, Nelemans PJ, Valentini V, journalName=Lancet Oncol, refType=null, unstructuredReference=Maas M, Nelemans PJ, Valentini V, et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data[J]. Lancet Oncol, 2010, 11(9): 835-844., articleTitle=Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data, refAbstract=null), Reference(id=1199376215632081249, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2005, volume=23, issue=34, pageStart=8688, pageEnd=8696, url=null, language=null, rfNumber=[26], rfOrder=25, authorNames=Rödel C, Martus P, Papadoupolos T, journalName=J Clin Oncol, refType=null, unstructuredReference=Rödel C, Martus P, Papadoupolos T, et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer[J]. J Clin Oncol, 2005, 23(34): 8688-8696., articleTitle=Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer, refAbstract=null), Reference(id=1199376215766298987, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2017, volume=99, issue=2, pageStart=417, pageEnd=426, url=null, language=null, rfNumber=[27], rfOrder=26, authorNames=Markovina S, Youssef F, Roy A, journalName=Int J Radiat Oncol Biol Phys, refType=null, unstructuredReference=Markovina S, Youssef F, Roy A, et al. Improved metastasis- and disease-free survival with preoperative sequential short-course radiation therapy and FOLFOX chemotherapy for rectal cancer compared with neoadjuvant long-course chemoradiotherapy: results of a matched pair analysis[J]. Int J Radiat Oncol Biol Phys, 2017, 99(2): 417-426., articleTitle=Improved metastasis- and disease-free survival with preoperative sequential short-course radiation therapy and FOLFOX chemotherapy for rectal cancer compared with neoadjuvant long-course chemoradiotherapy: results of a matched pair analysis, refAbstract=null), Reference(id=1199376215976014203, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2004, volume=240, issue=4, pageStart=711, pageEnd=717, url=null, language=null, rfNumber=[28], rfOrder=27, authorNames=Habr-Gama A, Perez RO, Nadalin W, journalName=Ann Surg, refType=null, unstructuredReference=Habr-Gama A, Perez RO, Nadalin W, et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results[J]. Ann Surg, 2004, 240(4): 711-717., articleTitle=Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results, refAbstract=null), Reference(id=1199376216072483203, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2018, volume=391, issue=10139, pageStart=2537, pageEnd=2545, url=null, language=null, rfNumber=[29], rfOrder=28, authorNames=van der Valk MJM, Hilling DE, Bastiaannet E, journalName=Lancet, refType=null, unstructuredReference=van der Valk MJM, Hilling DE, Bastiaannet E, et al. IWWD Consortium. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study[J]. Lancet, 2018, 391(10139): 2537-2545., articleTitle=IWWD Consortium. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study, refAbstract=null), Reference(id=1199376216185729417, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2017, volume=2, issue=7, pageStart=501, pageEnd=513, url=null, language=null, rfNumber=[30], rfOrder=29, authorNames=Dossa F, Chesney TR, Acuna SA, journalName=Lancet Gastroenterol Hepatol, refType=null, unstructuredReference=Dossa F, Chesney TR, Acuna SA, et al. A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2017, 2(7): 501-513., articleTitle=A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis, refAbstract=null), Reference(id=1199376216278004110, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2021, volume=18, issue=12, pageStart=805, pageEnd=816, url=null, language=null, rfNumber=[31], rfOrder=30, authorNames=Fokas E, Appelt A, Glynne-Jones R, journalName=Nat Rev Clin Oncol, refType=null, unstructuredReference=Fokas E, Appelt A, Glynne-Jones R, et al. International consensus recommendations on key outcome measures for organ preservation after (chemo)radiotherapy in patients with rectal cancer[J]. Nat Rev Clin Oncol, 2021, 18(12): 805-816., articleTitle=International consensus recommendations on key outcome measures for organ preservation after (chemo)radiotherapy in patients with rectal cancer, refAbstract=null), Reference(id=1199376216420610455, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=6, pageStart=1136, pageEnd=1146, url=null, language=null, rfNumber=[32], rfOrder=31, authorNames=Bando H, Tsukada Y, Inamori K, journalName=Clin Cancer Res, refType=null, unstructuredReference=Bando H, Tsukada Y, Inamori K, et al. Preoperative chemoradiotherapy plus nivolumab before surgery in patients with microsatellite stable and microsatellite instability-high locally advanced rectal cancer[J]. Clin Cancer Res, 2022, 28(6): 1136-1146., articleTitle=Preoperative chemoradiotherapy plus nivolumab before surgery in patients with microsatellite stable and microsatellite instability-high locally advanced rectal cancer, refAbstract=null), Reference(id=1199376216525468063, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2021, volume=9, issue=11, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[33], rfOrder=32, authorNames=Lin Z, Cai M, Zhang P, journalName=Immunother Cancer, refType=null, unstructuredReference=Lin Z, Cai M, Zhang P, et al. Phase Ⅱ, single-arm trial of preoperative short-course radiotherapy followed by chemotherapy and camrelizumab in locally advanced rectal cancer[J]. Immunother Cancer, 2021, 9(11): e003554., articleTitle=Phase Ⅱ, single-arm trial of preoperative short-course radiotherapy followed by chemotherapy and camrelizumab in locally advanced rectal cancer, refAbstract=null), Reference(id=1199376216605159845, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2015, volume=16, issue=null, pageStart=e498, pageEnd=e509, url=null, language=null, rfNumber=[34], rfOrder=33, authorNames=Sharabi AB, Lim M, DeWeese TL, journalName=Lancet Oncol, refType=null, unstructuredReference=Sharabi AB, Lim M, DeWeese TL, et al. Radiation and checkpoint blockade immunotherapy: radiosensitisation and potential mechanisms of synergy[J]. Lancet Oncol, 2015, 16: e498-e509., articleTitle=Radiation and checkpoint blockade immunotherapy: radiosensitisation and potential mechanisms of synergy, refAbstract=null), Reference(id=1199376216739377583, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2016, volume=1, issue=3, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[35], rfOrder=34, authorNames=Spiotto M, Fu YX, Weichselbaum RR, journalName=Immunol, refType=null, unstructuredReference=Spiotto M, Fu YX, Weichselbaum RR. The intersection of radiotherapy and immunotherapy: mechanisms and clinical implications[J]. Immunol, 2016, 1(3): EAAG1266., articleTitle=The intersection of radiotherapy and immunotherapy: mechanisms and clinical implications, refAbstract=null), Reference(id=1199376216848429493, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2019, volume=37, issue=null, pageStart=TPS721, pageEnd=null, url=null, language=null, rfNumber=[36], rfOrder=35, authorNames=George TJ, Yothers G, Rahma OE, journalName=J Clin Oncol, refType=null, unstructuredReference=George TJ, Yothers G, Rahma OE, et al. A phase Ⅱ clinical trial platform for sensitization testing using total neoadjuvant therapy (TNT) in rectal cancer: Nrg-GI002[J]. J Clin Oncol, 2019, 37(Suppl 4): TPS721., articleTitle=A phase Ⅱ clinical trial platform for sensitization testing using total neoadjuvant therapy (TNT) in rectal cancer: Nrg-GI002, refAbstract=null), Reference(id=1199376216961675710, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2020, volume=38, issue=null, pageStart=TPS4122, pageEnd=null, url=null, language=null, rfNumber=[37], rfOrder=36, authorNames=Capdevila J, Macias Declara I, Carmen Riesco Martinez M, journalName=J Clin Oncol, refType=null, unstructuredReference=Capdevila J, Macias Declara I, Carmen Riesco Martinez M, et al. Phase Ⅱ study of durvalumab plus total neoadjuvant therapy (TNT) in locally advanced rectal cancer: the GEMCAD-1703 DUREC trial[J]. J Clin Oncol, 2020, 38(Suppl 15): TPS4122., articleTitle=Phase Ⅱ study of durvalumab plus total neoadjuvant therapy (TNT) in locally advanced rectal cancer: the GEMCAD-1703 DUREC trial, refAbstract=null), Reference(id=1199376217049756098, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2020, volume=20, issue=1, pageStart=831, pageEnd=null, url=null, language=null, rfNumber=[38], rfOrder=37, authorNames=Shamseddine A, Zeidan YH, Khalifeh M, journalName=BMC Cancer, refType=null, unstructuredReference=Shamseddine A, Zeidan YH, Khalifeh M, et al. Short-course radiation followed by mFOLFOX-6 plus avelumab for locally-advanced rectal adenocarcinoma[J]. BMC Cancer, 2020, 20(1): 831., articleTitle=Short-course radiation followed by mFOLFOX-6 plus avelumab for locally-advanced rectal adenocarcinoma, refAbstract=null), Reference(id=1199376217192362440, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2020, volume=38, issue=null, pageStart=TPS4117, pageEnd=null, url=null, language=null, rfNumber=[39], rfOrder=38, authorNames=Romesser PB, Holliday EB, Phillip T, journalName=J Clin Oncol, refType=null, unstructuredReference=Romesser PB, Holliday EB, Phillip T, et al. A multicenter phase Ⅰb/Ⅱ study of DNA-PK inhibitor peposertib (M3814) in combination with capecitabine and radiotherapy in patients with locally advanced rectal cancer[J]. J Clin Oncol, 2020, 38(Suppl 15): TPS4117., articleTitle=A multicenter phase Ⅰb/Ⅱ study of DNA-PK inhibitor peposertib (M3814) in combination with capecitabine and radiotherapy in patients with locally advanced rectal cancer, refAbstract=null), Reference(id=1199376217272054221, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2020, volume=38, issue=null, pageStart=4102, pageEnd=null, url=null, language=null, rfNumber=[40], rfOrder=39, authorNames=Fernandez-Martos C, Machado I, Pericay C, journalName=J Clin Oncol, refType=null, unstructuredReference=Fernandez-Martos C, Machado I, Pericay C, et al. Randomized phase Ⅱ trial of modified (m) FOLFOX6 induction chemotherapy with or without aflibercept before standard chemoradiotherapy (CRT) and total mesorectal excision (TME) in patients with high-risk rectal adenocarcinoma (HRRC): final results of the GEMCAD 1402, and by molecular subtypes[J]. J Clin Oncol, 2020, 38(Suppl 15): 4102., articleTitle=Randomized phase Ⅱ trial of modified (m) FOLFOX6 induction chemotherapy with or without aflibercept before standard chemoradiotherapy (CRT) and total mesorectal excision (TME) in patients with high-risk rectal adenocarcinoma (HRRC): final results of the GEMCAD 1402, and by molecular subtypes, refAbstract=null), Reference(id=1199376217355940306, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2022, volume=303, issue=2, pageStart=351, pageEnd=358, url=null, language=null, rfNumber=[41], rfOrder=40, authorNames=Shin J, Seo N, Baek SE, journalName=Radiology, refType=null, unstructuredReference=Shin J, Seo N, Baek SE, et al. MRI radiomics model predicts pathologic complete response of rectal cancer following chemoradiotherapy[J]. Radiology, 2022, 303(2): 351-358., articleTitle=MRI radiomics model predicts pathologic complete response of rectal cancer following chemoradiotherapy, refAbstract=null), Reference(id=1199376217452409306, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2022, volume=4, issue=1, pageStart=e8, pageEnd=e17, url=null, language=null, rfNumber=[42], rfOrder=41, authorNames=Feng L, Liu Z, Li C, journalName=Lancet Digit Health, refType=null, unstructuredReference=Feng L, Liu Z, Li C, et al. Development and validation of a radiopathomics model to predict pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a multicentre observational study[J]. Lancet Digit Health, 2022, 4(1): e8-e17., articleTitle=Development and validation of a radiopathomics model to predict pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a multicentre observational study, refAbstract=null), Reference(id=1199376217527906782, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2017, volume=23, issue=23, pageStart=7253, pageEnd=7262, url=null, language=null, rfNumber=[43], rfOrder=42, authorNames=Liu Z, Zhang XY, Shi YJ, journalName=Clin Cancer Res, refType=null, unstructuredReference=Liu Z, Zhang XY, Shi YJ, et al. Radiomics analysis for evaluation of pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer[J]. Clin Cancer Res, 2017, 23(23): 7253-7262., articleTitle=Radiomics analysis for evaluation of pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer, refAbstract=null), Reference(id=1199376217720844770, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2021, volume=18, issue=8, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[44], rfOrder=43, authorNames=Wang Y, Yang L, Bao H, journalName=PLoS Med, refType=null, unstructuredReference=Wang Y, Yang L, Bao H, et al. Utility of ctDNA in predicting response to neoadjuvant chemoradiotherapy and prognosis assessment in locally advanced rectal cancer: A prospective cohort study[J]. PLoS Med, 2021, 18(8): e1003741., articleTitle=Utility of ctDNA in predicting response to neoadjuvant chemoradiotherapy and prognosis assessment in locally advanced rectal cancer: A prospective cohort study, refAbstract=null), Reference(id=1199376217892811239, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199337301408052223, doi=null, pmid=null, pmcid=null, year=2020, volume=26, issue=19, pageStart=5198, pageEnd=5207, url=null, language=null, rfNumber=[45], rfOrder=44, authorNames=El Sissy C, Kirilovsky A, Van den Eynde M, journalName=Clin Cancer Res, refType=null, unstructuredReference=El Sissy C, Kirilovsky A, Van den Eynde M, et al. A diagnostic biopsy-adapted immunoscore predicts response to neoadjuvant treatment and selects patients with rectal cancer eligible for a Watch-and-Wait strategy[J]. 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局部进展期直肠癌的全程新辅助治疗模式
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周荻 , 周珺珺 , 胡斌 , 陈海燕 *
解放军医学杂志 | 直肠癌手术及围手术期治疗策略专题 2024,49(1): 17-22
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解放军医学杂志 | 直肠癌手术及围手术期治疗策略专题 2024, 49(1): 17-22
局部进展期直肠癌的全程新辅助治疗模式
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周荻, 周珺珺, 胡斌, 陈海燕*
作者信息
  • 上海交通大学医学院附属仁济医院放射诊疗科，上海 200127

    • 周荻，硕士研究生，主治医师，主要从事腹盆腔恶性肿瘤的放疗及综合治疗研究

    陈海燕，医学博士，副主任医师，上海市医学会放疗专业委员会青年委员，中国研究型医院学会放射肿瘤学专业委员会委员，中国抗癌协会小儿肿瘤专业委员会放疗学组委员。目前承担医工交叉青年项目及国家自然科学基金青年项目等多项课题。

通讯作者:

陈海燕，E-mail：
Total neoadjuvant therapy for locally advanced rectal cancer
Di Zhou, Jun-Jun Zhou, Bin Hu, Hai-Yan Chen*
Affiliations
  • Department of Radiation Oncology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
出版时间: 2024-01-28 doi: 10.11855/j.issn.0577-7402.2369.2023.0619
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摘要
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局部进展期直肠癌(LARC)目前公认的治疗模式为多学科综合治疗。标准术前同步放化疗可明显降低LARC的局部复发率，但不影响其远处转移发生率和总生存率，而全程新辅助治疗(TNT)通过提高化疗强度、延长放疗至手术的时间，从而提高肿瘤缓解率，可明显改善无病生存率和无转移生存率。TNT模式可明显提高患者的依从性，使全身化疗完成度更高，能带来最大程度的肿瘤退缩，不但能改善远期生存，也能增加器官功能保留的机会。对于远处转移风险高或器官功能保留意愿强的LARC患者，TNT是一种极具潜力的治疗模式。随着免疫治疗在TNT领域的应用，TNT模式不断拓展；同时，疗效预测标志物的探索将为个体化治疗奠定基础。

局部进展期直肠癌  /  全程新辅助治疗  /  新辅助放化疗  /  无病生存  /  器官保留

Diagnosis and treatment of locally advanced rectal cancer (LARC) must be completed by a collaborative model of a multi-disciplinary team. The neoadjuvant chemoradiotherapy significantly reduced the local recurrence rate of LARC, but did not affect the occurrence of distant metastases and overall survival. Total neoadjuvant therapy (TNT), by strengthening the intensity of chemotherapy and extending the time from radiotherapy to surgery, can improve the tumor response rate as well as disease-free survival rate and metastasis-free survival rate. It offers advantages such as enhancing the compliance with chemotherapy, maximizing tumor regression, improving survival and increasing the chance of organ preservation. TNT is a promising treatment model for LARC patients with high risk of distant metastasis or strong desire for organ preservation. With the application of immunotherapy in the field of TNT, the mode of TNT continues to expand. And the exploration of therapeutic predictive markers will help to provide a personalized treatment for patients.

locally advanced rectal cancer  /  total neoadjuvant therapy  /  neoadjuvant chemoradiotherapy  /  disease-free survival  /  organ preservation
周荻, 周珺珺, 胡斌, 陈海燕. 局部进展期直肠癌的全程新辅助治疗模式. 解放军医学杂志, 2024 , 49 (1) : 17 -22 . DOI: 10.11855/j.issn.0577-7402.2369.2023.0619
Di Zhou, Jun-Jun Zhou, Bin Hu, Hai-Yan Chen. Total neoadjuvant therapy for locally advanced rectal cancer[J]. Medical Journal of Chinese People’s Liberation Army, 2024 , 49 (1) : 17 -22 . DOI: 10.11855/j.issn.0577-7402.2369.2023.0619
正文
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2022年结直肠癌居全球恶性肿瘤总体发病率第3位，全球常见癌症死亡原因第3位，确诊时近1/3的患者为局部进展[1]。对于局部进展期直肠癌(locally advanced rectal cancer，LARC)，新辅助放化疗(neoadjuvant chemoradiotherapy，nCRT)联合全直肠系膜切除术(total mesorectal excision，TME)的多学科治疗策略显著提高了肿瘤局部控制率，改善了患者预后。其中nCRT是指以氟尿嘧啶为基础的术前同步放化疗，通常采用卡培他滨或5-氟尿嘧啶(5-fluorouracil，5-FU)输注或5-FU推注+亚叶酸钙(leucovorin，LV)联合长程放疗的方案，也称为标准新辅助治疗。这一诊疗方式虽可降低LARC的局部复发率，但治疗后远处转移发生率高达29%~39%[2]，成为治疗失败的主要原因[2-3]，直接影响总生存率。如何有效降低LARC患者远处转移的风险是提高疗效、改善生存的关键。对于高复发风险的LARC患者(盆腔MRI定义为cT4a/b、cN2、直肠系膜筋膜受累、壁外血管侵犯阳性或盆腔淋巴结转移)，全程新辅助治疗(total neoadjuvant therapy，TNT)已成为新标准，是指在LARC围手术期治疗中，将更多或全部术后辅助化疗前移至术前与放疗结合再进行TME手术的综合治疗策略[4-5]。本文对此作一详细阐述，同时探讨未来TNT研究发展的方向。
1 TNT模式
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TNT的常用模式包括：(1)短程大分割放疗后序贯巩固化疗，再进行TME；(2)长程同步放化疗后序贯巩固化疗，再进行TME；(3)诱导化疗后行长程同步放化疗，再进行TME。TNT模式中，新辅助化疗根据其在放疗前或放疗后进行的顺序，分别称为诱导化疗和巩固化疗(后文中诱导化疗和巩固化疗均特指在TNT治疗的前提下)。目前有关TNT中化疗的具体方案及疗程等暂无统一标准，参考既往随机对照研究，可选化疗方案包括CAPOX、FOLFOX等两药方案，以及FOLFIRINOX三药方案[6-10]。研究发现，TNT可有效降低远处转移的发生率，并被美国国立综合癌症网络(National Comprehensive Cancer Network，NCCN)和欧洲肿瘤内科学会指南(European Society for Medical Oncology，ESMO)推荐应用于LARC的治疗[11]。与标准新辅助治疗相比，TNT化疗强度高，且延长了放疗至手术的时间。此外，TNT还具有降低肿瘤分期、增加患者治疗依从性、早期有效地针对隐匿性微转移、有助于评估化疗敏感性等优点。
早在2017年美国临床肿瘤学会(American Society of Clinical Oncology，ASCO)即提出改进LARC的治疗模式，近年来越来越多的国内外研究证实TNT模式能明显增加患者的依从性，提高肿瘤缓解率，改善生存获益率，提供更多器官功能保留的机会。
2 TNT近期疗效
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术前新辅助治疗多以病理完全缓解(pathologic complete response，pCR)率作为近期疗效评估的指标。pCR是指手术切除样本(包括病灶瘤床区及其相应淋巴结)均无肿瘤细胞浸润，即肿瘤退缩分级(tumor regression grade，TRG) 0级。标准新辅助治疗的pCR率为4.2%~21.3%[12]，与新辅助化疗强度明显相关。既往研究发现，通过增强同步放化疗时的化疗强度有助于提高pCR率。如CAO/ARO/AIO-04[13]和FOWARC[14]研究显示，加用奥沙利铂可使pCR率从17.0%提高至27.5%。Des Guetz等[15]的Meta分析也支持该结论。除在5-FU或卡培他滨的基础上联合奥沙利铂外，另一种常用的联合治疗药物为伊立替康，我国CinClare研究[16]显示，卡培他滨同期联合伊立替康的同步放化疗可获得极高的pCR率(33.8%)，该研究的亮点为根据UGT1A1的基因型调整伊立替康用药剂量，且发现伊立替康在新辅助治疗中存在剂量效应关系，剂量越高，pCR率越高；同时试验组在同步放化疗的基础上序贯Xeliri方案的巩固化疗，进一步提高了pCR率。总之，TNT通过将全身化疗前移，实现了更高的新辅助化疗强度。
越来越多的证据表明，与放疗后12周内进行手术相比，放疗后延迟3个月或更长时间进行手术可获得更高的反应率[17-18]。Calvo等[19]发现，由于诱导化疗的参与，TNT组接受手术的时间较标准新辅助治疗组延迟1个月，且术后肿瘤降期情况明显优于标准新辅助治疗组。TIMING研究显示，术前较多的mFOLFOX6周期数以及较长的术前放化疗与手术时间间隔均与pCR率增高明显相关[20]。斯隆-凯特林癌症研究所(Memorial Sloan Kettering Cancer Center，MSKCC)的一项回顾性分析显示，TNT组近50.0%的患者放疗与手术间隔时间为8~12周，19.1%的患者>12周，而标准治疗组51.7%的患者<8周，仅14.5%的患者>12周。治疗模式的差异导致TNT组放疗与手术的间隔时间明显延长，同时TNT组完全缓解率[pCR+临床完全缓解(clinical complete response，cCR)]明显高于标准治疗组(35.7% vs. 21.3%)[21]。有研究发现，与传统的术前长程放疗(long-course preoperative radiotherapy，LCRT)相比，延长术前短程放疗(short-course preoperative radiotherapy，SCRT)与手术间隔时间可诱导较大的肿瘤退缩，且pCR率增高(10.4% vs. 2.2%)[22]。基于此，RAPIDO研究[7]比较了短程放疗后序贯巩固化疗(CAPOX或FOLFOX方案)联合TME(TNT组)与标准新辅助治疗联合TME(标准新辅助治疗组)的疗效，结果显示，TNT组pCR率较标准新辅助治疗组增高1倍(28% vs. 14%，P<0.001)。中国的多中心STELLAR研究[8]比较了LARC患者SCRT后序贯巩固化疗(4周期CAPOX方案)与标准新辅助治疗的近期疗效，证实SCRT序贯巩固化疗的TNT治疗模式的pCR+cCR率高于标准新辅助治疗(22.5% vs. 12.6%，P=0.036)。美国国家癌症数据库(National Cancer Data Base，NCDB)的回顾性分析发现，在LARC患者中，nCRT的pCR率约为13%，TNT则可达29.9%[23]。有Meta分析显示，TNT治疗后pCR率为17.2%~38.5%[12]。
3 TNT远期疗效
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标准新辅助治疗后获得pCR的患者局部肿瘤复发的可能性低，且较未达到pCR的患者生存预后好[24]。有研究分析标准新辅助治疗后患者的生存情况，结果显示，获得pCR患者的5年无远处转移生存率和总生存率分别为88.8%和87.6%，明显优于非pCR患者[25]。德国CAO/ARO/AIO-94研究[26]通过长期随访发现，pCR患者和非pCR患者5年无疾病生存率分别为86%和63%。
TNT的生存获益并非局限于达到pCR或cCR的患者。虽然TNT与nCRT在局部复发率方面无明显差异，但目前已有多项研究提示TNT能够明显提高患者的无病生存率。2017年Markovina等[27]比较了TNT与标准新辅助治疗的长期疗效，发现TNT组3年无病生存率(85% vs. 68%，P=0.032)和3年无远处转移生存率(88% vs. 70%，P=0.028)均明显高于标准新辅助治疗组，但两组3年总生存率无明显差异(96% vs. 88%，P=0.670)。RAPIDO研究[7]也证实，与标准新辅助治疗相比，TNT模式的3年疾病治疗相关失败率降低7%(30.4% vs. 23.9%，P=0.019)，3年无远处转移生存率提高近7%(26.8% vs. 20%，P=0.005)，差异均有统计学意义，且手术并发症未增加；同时两组不良反应和3年总生存率(均为89%)相似。PRODIGE 23研究[9]比较了TNT组[采用三药诱导化疗，即mFOLFIRINOX方案诱导化疗6个周期后序贯长程同步放化疗和TME，术后行3个月辅助化疗(6个周期mFOLFOX6或4个周期卡培他滨单药化疗)]与标准新辅助治疗组[采用标准新辅助治疗，即长程同步放化疗联合TME，术后行6个月辅助化疗(12个周期mFOLFOX6或8个周期卡培他滨单药化疗)]的远期疗效，结果显示，TNT组pCR率(27.5% vs. 11.7%，P<0.001)、3年无病生存率(75.7% vs. 68.5%，P=0.034)和3年无转移生存率(78.8% vs. 71.7%，P=0.017)均明显高于标准新辅助治疗组。STELLA研究[8]显示，TNT组总生存率明显高于标准新辅助治疗组(86.5% vs. 75.1%，P=0.036)，且两组3年无病生存率、无转移生存率和局部复发率差异无统计学意义。以上研究结果表明，TNT可减少远处转移的发生，甚至转化为生存获益。
4 TNT对器官功能保留的影响
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4.1 促进pCR转化为器官功能保留
直肠癌患者接受nCRT的另一目标是实现器官功能保留。研究显示，对于治疗后达到cCR的患者采取密切随访而不是手术治疗，其器官功能得以保留，同时生存未受到影响，即“观察等待”[28]。选择观察等待策略的患者经过10年随访，结果显示其总生存率为97.7%，无病生存率为84%。一项多中心注册的国际研究显示，cCR后选择观察等待策略患者的5年疾病特异性生存率可达94%，且仅8%的患者发生远处转移[29]。最近一项Meta分析发现，cCR后选择观察等待策略的患者与pCR患者在局部复发和癌症相关病死率方面均无统计学差异[30]。
4.2 不同TNT模式在器官功能保留方面的差异
相较标准新辅助治疗，TNT治疗后更多的患者达到cCR。局部疗效的提高为更高比例的器官功能保留提供了有利条件。在保留直肠功能方面，OPRA研究[10]是在接受TNT的Ⅱ期或Ⅲ期直肠癌患者中实现器官保留的探索。来自美国18家医疗中心的324例患者随机接受诱导化疗后CRT(INCT-CRT组，n=158)或CRT后巩固化疗(CRT-CNCT组，n=166)，经过TNT治疗后，INCT-CRT组71%的患者达到或接近cCR，并给予观察等待；CRT-CNCT组中该比例为76%；中位随访3年，INCT-CRT组40%的患者和CRT-CNCT组27%的患者出现肿瘤复发，所有复发患者均接受TME挽救性手术治疗。该研究还发现，90%的肿瘤复发发生在TNT后2年内。值得注意的是，肿瘤复发后接受TME的患者与初次再分期后接受TME的患者具有相似的生存结果，提示推迟手术至肿瘤复发时是无害的。无论是采取诱导化疗后CRT还是CRT后巩固化疗，这两种TNT模式的3年无病生存率均为76%，与既往3年无病生存率(75%)相似。然而，INCT-CRT组41%的患者实现3年无TME生存，而CRT-CNCT组这一比例高达53%。由此可见，很大比例的患者符合观察等待的条件，约50%的患者可在3年不降低生存率的情况下实现直肠器官功能保留。若以非手术治疗(non-operative management，NOM)和器官功能保留为目标，CRT-CNCT可能是首选的TNT模式。
2021年Fokas等[31]发表了直肠癌nCRT后器官保留主要测量指标的国际共识，共识中定义了直肠癌器官保留策略的10项临床终点指标，并提出关于确定cCR的最佳评估时间点的建议，该共识再次肯定了TNT在直肠癌器官功能保留中的作用，这也是未来个体化治疗的趋势之一。
5 TNT模式的探索
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除将全身化疗前移到新辅助治疗阶段，免疫治疗、新型放疗增敏剂或靶向药物与放疗联合也可能进一步拓宽TNT的范畴。
5.1 免疫治疗的前移
2019年日本的VOLTAGE研究[32]在LARC患者术前长程同步放化疗后序贯接受纳武利尤单抗治疗，结果显示，高度微卫星不稳定性(microsatellite instability-high，MSI-H)患者的pCR率达到60%，微卫星稳定(microsatellite stability，MSS)患者的pCR率也可达到30%。由此可见，在长程放疗后应用免疫单药的短期疗效不劣于化疗前移。华中科技大学同济医学院附属协和医院的小样本单臂Ⅱ期临床研究则在短程大分割放疗的基础上序贯使用CAPOX联合卡瑞利珠单抗，结果显示，错配修复完整(mismatch repair proficient，pMMR) LARC患者的pCR率高达46.2%[33]。短程大分割放疗理论上可调节肿瘤细胞的免疫原性，增强抗原特异性的CD8+ T细胞反应[34-35]，但短程放疗与免疫治疗相结合的治疗模式是否一定优于长程同步放化疗联合免疫治疗，仍待进一步研究证实。近年来多项Ⅱ期临床研究发现，放疗联合免疫治疗在MSS型LARC患者中的pCR率高于标准同步放化疗，但在高强度TNT治疗基础上联合免疫治疗，疗效暂时未见提高[36-38]，仍需进一步探究免疫耐药机制及筛选免疫治疗的获益人群。
5.2 其他药物
其他药物如替莫唑胺、PEP503(NBTXR3，一种纳米技术放疗增敏剂)、pepsertib(一种DNA蛋白激酶抑制剂)和aflibercept(一种血管生成抑制剂)等，也参与到LARC TNT模式中[39-40]，相关研究结果有望使LARC TNT模式更加多样化。
6 TNT疗效预测
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对于LARC TNT模式的疗效预测，主要集中于影像组学特征、循环肿瘤DNA(circulating tumor DNA，ctDNA)动态监测以及免疫微环境等方面。
影像组学的研究热点是根据患者初始MRI的肿瘤多样性特征来预测TNT模式的pCR率，如T2加权像、弥散加权成像、MR-TRG分级等，基于MRI的影像组学模型预测LARC TNT后病理缓解情况的准确性尚需在更大的多机构队列中进行验证，以建立其独立预测效能[41-43]。LARC患者TNT中ctDNA动态监测发现，ctDNA的基线特征、ctDNA突变清除率和新发突变与放化疗后肿瘤退缩相关[44]，此外，ctDNA联合MRI模型理论上对放化疗后pCR的预测价值更高。影像组学及ctDNA在TNT治疗前后的变化可能有助于选择新辅助治疗产生最大反应的患者，并避免不必要的手术治疗。
随着免疫治疗的前移，免疫微环境和免疫评分将有助于预测LARC患者新辅助免疫治疗的疗效[45]。VOLTAGE研究[32]发现，PD-L1表达≥1%且CD8/eTreg≥2.5的MSS型LARC患者的pCR率可达到100%。一项单臂Ⅱ期研究观察到PD-L1综合阳性评分(CPS)≥1分或肿瘤突变负荷(TMB)≥10的患者在短程放疗序贯化疗联合免疫治疗后可获得更高pCR率的趋势。此外，没有FGFR1-3缺失的患者似乎比FGFR1-3缺失的患者更有可能从短程放疗序贯化疗联合免疫治疗策略中获益(pCR率：55.6% vs. 0%)[33]。
7 总结与展望
收起
TNT是LARC一种有前景的治疗策略，可获得提高pCR的机会，理论上应与更长的总体生存期和无病生存期相对应，同时为更多的患者提供了器官功能保留的机会。目前为止的循证医学研究可观察到无病生存期的改善，而TNT对总体生存期的作用尚需更多前瞻性研究进一步评估。
TNT后患者手术方式的选择更为多样化和个体化：低危风险者可考虑联合局部切除手术，cCR或pCR者可选择观察等待策略。如何筛选出合适的患者，精准地评价cCR，从影像或基因表达等方面监测患者，以及选择合适的随访时间等，仍有待探讨。未来研究可集中于寻找更有效的标志物或预测模型，采用多组学分析和多维度综合评估以确定最有可能从TNT治疗中获益的人群，并预测TNT的疗效。
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参考文献 引证文献
排序方式：
[1]
Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2022[J]. CA Cancer J Clin, 2022, 72(1): 7-33.
[2]
Bosset JF, Calais G, Mineur L, et al. EORTC Radiation Oncology Group. Fluorouracil-based adjuvant chemotherapy after preoperative chemoradiotherapy in rectal cancer: long-term results of the EORTC 22921 randomised study[J]. Lancet Oncol, 2014, 15(2): 184-190.
[3]
Sainato A, Cernusco Luna Nunzia V, Valentini V, et al. No benefit of adjuvant fluorouracil leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): long term results of a randomized trial (I-CNR-RT)[J]. Radiother Oncol, 2014, 113(2): 223-229.
[4]
Chau I, Brown G, Cunningham D, et al. Neoadjuvant capecitabine and oxaliplatin followed by synchronous chemoradiation and total mesorectal excision in magnetic resonance imaging-defined poor-risk rectal cancer[J]. J Clin Oncol, 2006, 24(4): 668-674.
[5]
吴胜伟, 吴晓翔, 王志伟. 保留盆腔自主神经的腹腔镜全直肠系膜切除术对女性直肠癌患者术后复发及排尿和性生活质量的影响[J]. 新乡医学院学报, 2022, 39(6): 519-522.
[6]
Ciseł B, Pietrzak L, Michalski W, et al. Long-course preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for clinical T4 and fixed clinical T3 rectal cancer: long-term results of the randomized Polish Ⅱ study[J]. Ann Oncol, 2019, 30(8): 1298-1303.
[7]
Bahadoer RR, Dijkstra EA, van Etten B, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial[J]. Lancet Oncol, 2021, 22(1): 29-42.
[8]
Jin J, Tang Y, Hu C, et al. Multicenter, randomized, phase Ⅲ trial of short-term radiotherapy plus chemotherapy versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR)[J]. J Clin Oncol, 2022, 40(15): 1681-1692.
[9]
Conroy T, Lamfichekh N, Etienne PL, et al. Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiation in patients with locally advanced rectal cancer: final results of PRODIGE 23 phase Ⅲ trial, a UNICANCER GI trial[J]. J Clin Oncol, 2020, 38(Suppl 15): 4007.
[10]
Garcia-Aguilar J, Patil S, Gollub MJ, et al. Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy[J]. J Clin Oncol, 2022, 40(23): 2546-2556.
[11]
Benson AB, Venook AP, Al-Hawary MM, et al. Rectal Cancer, version 2.2018, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2018, 16(7): 874-901.
[12]
Tuta M, Boc N, Brecelj E, et al. Total neoadjuvant therapy vs standard therapy of locally advanced rectal cancer with high-risk factors for failure[J]. World J Gastrointest Oncol, 2021, 13(2): 119-130.
[13]
Rödel C, Graeven U, Fietkau R, et al. Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial[J]. Lancet Oncol, 2015, 16(8): 979-989.
[14]
Deng Y, Chi P, Lan P, et al. Neoadjuvant modified FOLFOX6 with or without radiation versus fluorouracil plus radiation for locally advanced rectal cancer: final results of the Chinese FOWARC trial[J]. J Clin Oncol, 2019, 37(34): 3223-3233.
[15]
Des Guetz G, Landre T, Bollet MA, et al. Is there a benefit of oxaliplatin in combination with neoadjuvant chemoradiotherapy for locally advanced rectal cancer? An updated meta-analysis[J]. Cancers (Basel), 2021, 13(23): 6035.
[16]
Zhu J, Liu A, Sun X, et al. Multicenter, randomized, phase Ⅲ trial of neoadjuvant chemoradiation with capecitabine and irinotecan guided by UGT1A1 status in patients with locally advanced rectal cancer[J]. J Clin Oncol, 2020, 38(36): 4231-4239.
[17]
Habr-Gama A, Perez RO, Proscurshim I, et al. Interval between surgery and neoadjuvant chemoradiation therapy for distal rectal cancer: does delayed surgery have an impact on outcome?[J]. Int J Radiat Oncol Biol Phys, 2008, 71(4): 1181-1188.
[18]
Kalady MF, de Campos-Lobato LF, Stocchi L, et al. Predictive factors of pathologic complete response after neoadjuvant chemoradiation for rectal cancer[J]. Ann Surg, 2009, 250(4): 582-589.
[19]
Calvo FA, Serrano FJ, Diaz-González JA, et al. Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation[J]. Ann Oncol, 2006, 17(7): 1103-1110.
[20]
Garcia-Aguilar J, Chow OS, Smith DD, et al. Timing of rectal cancer response to chemoradiation consortium. Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial[J]. Lancet Oncol, 2015, 16(8): 957-966.
[21]
Cercek A, Roxburgh CSD, Strombom P, et al. Adoption of total neoadjuvant therapy for locally advanced rectal cancer[J]. JAMA Oncol, 2018, 4(6): e180071.
[22]
Erlandsson J, Lörinc E, Ahlberg M, et al. Tumour regression after radiotherapy for rectal cancer: results from the randomised Stockholm Ⅲ trial[J]. Radiother Oncol, 2019, 135: 178-186.
[23]
Lorimer PD, Motz BM, Kirks RC, et al. Pathologic complete response rates after neoadjuvant treatment in rectal cancer: an analysis of the National Cancer Database[J]. Ann Surg Oncol, 2017, 24(8): 2095-2103.
[24]
García-Aguilar J, Hernandez de Anda E, Sirivongs P, et al. A pathologic complete response to preoperative chemoradiation is associated with lower local recurrence and improved survival in rectal cancer patients treated by mesorectal excision[J]. Dis Colon Rectum, 2003, 46(3): 298-304.
[25]
Maas M, Nelemans PJ, Valentini V, et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data[J]. Lancet Oncol, 2010, 11(9): 835-844.
[26]
Rödel C, Martus P, Papadoupolos T, et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer[J]. J Clin Oncol, 2005, 23(34): 8688-8696.
[27]
Markovina S, Youssef F, Roy A, et al. Improved metastasis- and disease-free survival with preoperative sequential short-course radiation therapy and FOLFOX chemotherapy for rectal cancer compared with neoadjuvant long-course chemoradiotherapy: results of a matched pair analysis[J]. Int J Radiat Oncol Biol Phys, 2017, 99(2): 417-426.
[28]
Habr-Gama A, Perez RO, Nadalin W, et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results[J]. Ann Surg, 2004, 240(4): 711-717.
[29]
van der Valk MJM, Hilling DE, Bastiaannet E, et al. IWWD Consortium. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study[J]. Lancet, 2018, 391(10139): 2537-2545.
[30]
Dossa F, Chesney TR, Acuna SA, et al. A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2017, 2(7): 501-513.
[31]
Fokas E, Appelt A, Glynne-Jones R, et al. International consensus recommendations on key outcome measures for organ preservation after (chemo)radiotherapy in patients with rectal cancer[J]. Nat Rev Clin Oncol, 2021, 18(12): 805-816.
[32]
Bando H, Tsukada Y, Inamori K, et al. Preoperative chemoradiotherapy plus nivolumab before surgery in patients with microsatellite stable and microsatellite instability-high locally advanced rectal cancer[J]. Clin Cancer Res, 2022, 28(6): 1136-1146.
[33]
Lin Z, Cai M, Zhang P, et al. Phase Ⅱ, single-arm trial of preoperative short-course radiotherapy followed by chemotherapy and camrelizumab in locally advanced rectal cancer[J]. Immunother Cancer, 2021, 9(11): e003554.
[34]
Sharabi AB, Lim M, DeWeese TL, et al. Radiation and checkpoint blockade immunotherapy: radiosensitisation and potential mechanisms of synergy[J]. Lancet Oncol, 2015, 16: e498-e509.
[35]
Spiotto M, Fu YX, Weichselbaum RR. The intersection of radiotherapy and immunotherapy: mechanisms and clinical implications[J]. Immunol, 2016, 1(3): EAAG1266.
[36]
George TJ, Yothers G, Rahma OE, et al. A phase Ⅱ clinical trial platform for sensitization testing using total neoadjuvant therapy (TNT) in rectal cancer: Nrg-GI002[J]. J Clin Oncol, 2019, 37(Suppl 4): TPS721.
[37]
Capdevila J, Macias Declara I, Carmen Riesco Martinez M, et al. Phase Ⅱ study of durvalumab plus total neoadjuvant therapy (TNT) in locally advanced rectal cancer: the GEMCAD-1703 DUREC trial[J]. J Clin Oncol, 2020, 38(Suppl 15): TPS4122.
[38]
Shamseddine A, Zeidan YH, Khalifeh M, et al. Short-course radiation followed by mFOLFOX-6 plus avelumab for locally-advanced rectal adenocarcinoma[J]. BMC Cancer, 2020, 20(1): 831.
[39]
Romesser PB, Holliday EB, Phillip T, et al. A multicenter phase Ⅰb/Ⅱ study of DNA-PK inhibitor peposertib (M3814) in combination with capecitabine and radiotherapy in patients with locally advanced rectal cancer[J]. J Clin Oncol, 2020, 38(Suppl 15): TPS4117.
[40]
Fernandez-Martos C, Machado I, Pericay C, et al. Randomized phase Ⅱ trial of modified (m) FOLFOX6 induction chemotherapy with or without aflibercept before standard chemoradiotherapy (CRT) and total mesorectal excision (TME) in patients with high-risk rectal adenocarcinoma (HRRC): final results of the GEMCAD 1402, and by molecular subtypes[J]. J Clin Oncol, 2020, 38(Suppl 15): 4102.
[41]
Shin J, Seo N, Baek SE, et al. MRI radiomics model predicts pathologic complete response of rectal cancer following chemoradiotherapy[J]. Radiology, 2022, 303(2): 351-358.
[42]
Feng L, Liu Z, Li C, et al. Development and validation of a radiopathomics model to predict pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a multicentre observational study[J]. Lancet Digit Health, 2022, 4(1): e8-e17.
[43]
Liu Z, Zhang XY, Shi YJ, et al. Radiomics analysis for evaluation of pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer[J]. Clin Cancer Res, 2017, 23(23): 7253-7262.
[44]
Wang Y, Yang L, Bao H, et al. Utility of ctDNA in predicting response to neoadjuvant chemoradiotherapy and prognosis assessment in locally advanced rectal cancer: A prospective cohort study[J]. PLoS Med, 2021, 18(8): e1003741.
[45]
El Sissy C, Kirilovsky A, Van den Eynde M, et al. A diagnostic biopsy-adapted immunoscore predicts response to neoadjuvant treatment and selects patients with rectal cancer eligible for a Watch-and-Wait strategy[J]. Clin Cancer Res, 2020, 26(19): 5198-5207.
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doi: 10.11855/j.issn.0577-7402.2369.2023.0619
  • 接收时间：2022-11-09
  • 首发时间：2025-11-23
  • 出版时间：2024-01-28
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  • 收稿日期：2022-11-09
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    上海交通大学医学院附属仁济医院放射诊疗科，上海 200127

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