盆腔放疗(RT)治疗直肠癌伴同步肝转移的简要综述。

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2019-04-21 eCollection Date: 2019-01-01 DOI:10.1155/2019/5239042
Omer Sager, Ferrat Dincoglan, Selcuk Demiral, Bora Uysal, Hakan Gamsiz, Bahar Dirican, Murat Beyzadeoglu
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引用次数: 9

摘要

背景和目的:结直肠癌是一种非常常见的癌症,是全球癌症相关死亡率的主要原因,是一个主要的健康问题。肝脏是结直肠癌转移扩散的一个非常常见的部位,虽然近一半的患者在其疾病过程中发生转移,但在15%至25%的病例中检测到同步肝转移。在这种情况下,没有标准化的治疗方法,对于同步肝转移的直肠癌的多模式治疗的最佳顺序也没有共识。方法:在此,我们回顾盆腔放射治疗(RT)作为直肠癌同步肝转移的潜在治愈或姑息性治疗的一部分。结果:越来越多的证据表明盆腔放疗有助于IV期直肠癌患者的后续手术,改善局部肿瘤控制,实现症状缓解。引入卓越的成像能力和现代放射治疗方法,如强度调制放射治疗(IMRT)和图像引导放射治疗(IGRT),在现代提供了更高的辐射传递精度和毒性谱。结论:即使在伴有同步肝转移的IV期直肠癌中,通过积极治疗原发肿瘤和转移的患者,也有可能延长生存期和治愈。尽管在治疗方式的顺序上缺乏共识,盆腔RT可以作为多学科管理的关键组成部分。原发性直肠肿瘤和肝转移的可切除性、患者偏好、合并症、症状学和后勤问题应在制定最佳患者管理决策时充分考虑。
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A Concise Review of Pelvic Radiation Therapy (RT) for Rectal Cancer with Synchronous Liver Metastases.

Background and objective: Colorectal cancer is a major health concern as a very common cancer and a leading cause of cancer-related mortality worldwide. The liver is a very common site of metastatic spread for colorectal cancers, and, while nearly half of the patients develop metastases during the course of their disease, synchronous liver metastases are detected in 15% to 25% of cases. There is no standardized treatment in this setting and no consensus exists on optimal sequencing of multimodality management for rectal cancer with synchronous liver metastases.

Methods: Herein, we review the use of pelvic radiation therapy (RT) as part of potentially curative or palliative management of rectal cancer with synchronous liver metastases.

Results: There is accumulating evidence on the utility of pelvic RT for facilitating subsequent surgery, improving local tumor control, and achieving palliation of symptoms in patients with stage IV rectal cancer. Introduction of superior imaging capabilities and contemporary RT approaches such as Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) offer improved precision and toxicity profile of radiation delivery in the modern era.

Conclusion: Even in the setting of stage IV rectal cancer with synchronous liver metastases, there may be potential for extended survival and cure by aggressive management of primary tumor and metastases in selected patients. Despite lack of consensus on sequencing of treatment modalities, pelvic RT may serve as a critical component of multidisciplinary management. Resectability of primary rectal tumor and liver metastases, patient preferences, comorbidities, symptomatology, and logistical issues should be thoroughly considered in decision making for optimal management of patients.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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