一例KRAS野生型转移性直肠癌患者的多线系统与局部治疗管理：病例报告

Multiline Systemic and Local Therapy Management in a Patient with KRAS Wild-Type Metastatic Colorectal Cancer: A Case Report

摘要: 目的：本研究分析一例晚期RAS野生型转移性直肠癌患者的全程治疗方案，旨在为类似病例的临床管理提供参考。方法：结合结直肠癌临床实践指南与循证医学证据，根据患者具体临床特征制定个体化治疗策略。结果：依据现行权威标准，该患者接受了包含靶向药物、化学治疗及序贯局部干预的多线系统治疗，最终实现多次疾病控制，总生存期超过五年。结论：对于晚期RAS野生型转移性直肠癌，分子分型对靶向治疗具有重要指导价值。临床管理应遵循循证指南原则，注重系统治疗与局部干预的整合应用。在标准治疗方案有限的后线治疗阶段，需综合患者意愿、体能状态及现有临床证据等关键因素，制定个体化治疗策略以优化临床结局。

Abstract: Objective: This study analyzes the multiline treatment regimen for a patient with advanced RAS wild-type metastatic rectal cancer and aims to offer insights for the clinical management of similar cases. Methods: An individualized therapeutic strategy was developed in accordance with clinical practice guidelines and evidence‑based literature on colorectal cancer, taking into account the patient’s specific clinical profile. Results: Guided by current authoritative standards, the patient received multiline systemic therapy comprising targeted agents, chemotherapy, and sequential local interventions. This approach led to repeated disease control and an overall survival exceeding five years. Conclusion: In advanced RAS wild-type metastatic rectal cancer, molecular subtyping is critical for guiding targeted therapy. Management should adhere to evidence-based guidelines and integrate systemic with local treatment modalities. In later-line settings with limited standard options, treatment personalization must incorporate key factors such as patient preferences, performance status, and available clinical evidence to optimize outcomes.