Neoadjuvant strategy for locally advanced colorectal cancer based organ preservation
10.3760/cma.j.cn441530-20231231-00235
- VernacularTitle:基于器官保留的局部进展期结直肠癌新辅助治疗研究进展
- Author:
Zehua WU
1
;
Yi CHENG
;
Huabin HU
;
Jianwei ZHANG
;
Yanhong DENG
Author Information
1. 中山大学附属第六医院肿瘤内科 广州市黄埔区中六生物医学创新研究院，广州 510655
- Keywords:
Rectal neoplasms, locally advanced;
Microsatellite stablility;
Neoadjuvant therapy;
Clinical complete response;
Organ preservation
- From:
Chinese Journal of Gastrointestinal Surgery
2024;27(4):416-423
- CountryChina
- Language:Chinese
-
Abstract:
Neoadjuvant therapy for locally advanced colorectal cancer has made great progress in the past 20 years, but there are still limitations such as side effects, organ dysfunction and unsatisfactory control of metastasis. In recent years, with the improvement of surgical techniques and further development of molecular research, how to further improve local control, reduce distant metastasis, and even avoid surgery according to clinical remission to achieve organ preservation, is the current demand and research goal. With the advancement of molecular research, colorectal cancer has different treatment strategies based on microsatellite status. For patients with microsatellite instability locally advanced colorectal cancer, immune checkpoint inhibitor therapy significantly increased the pathologic complete response rate, reduced the incidence of adverse events and improved organ function compared with conventional chemoradiotherapy. For patients with microsatellite stable locally advanced colon cancer, neoadjuvant therapy is still in the exploratory stage. The standard of care is surgery combined with perioperative chemotherapy. For microsatellite stable locally advanced rectal cancer, the complete response rate is improved by enhancing neoadjuvant therapy, which helps to preserve organs. On the other hand, selective radiotherapy preserves organ function and improves quality of life. This article reviews the neoadjuvant treatment strategies for locally advanced colorectal cancer based on organ-sparing strategies.
