1例局部进展期直肠癌新辅助治疗后病理完全缓解的治疗并文献复习

Treatment of a Case of Locally Advanced Rectal Cancer in Pathological Complete Response after Neoadjuvant Therapy and Literature Review

摘要: 目前最新数据显示结直肠癌在全球发病率与死亡率分别位居第3位和第2位，术前新辅助治疗联合全直肠系膜切除(total mesorectal excision, TME)已成为进展期直肠癌的标准化治疗方案。局部进展期直肠癌(LARC)患者目前术前新辅助治疗后获得病理完全缓解(pCR)较为少见，但通常生存预后更好。本文报告了一例LARC患者成功接受了新辅助治疗方案，接受了保留肛门这一重要器官的根治性手术，并获得令人满意的pCR结果。在回肠造口还纳术后16个月内明显改善了生活质量，后续的复查中并未出现复发。我们希望通过该病例报告对之后的LARC患者的治疗提供参考，当然，对该患者的长期随访以及未来大型的临床循证研究才是评估该方案有效性的理论支持。

Abstract: The recent available data show that colorectal cancer (CRC) as the third most diagnosed cancer and the second leading cause of cancer death globally, and preoperative neoadjuvant therapy combined with total mesorectal excision (TME) has become a standardized treatment option for progressive rectal cancer. Patients with locally advanced rectal cancer (LARC) currently achieve pathological complete response (pCR) after preoperative neoadjuvant therapy more rarely, but usually have a better survival prognosis. In this paper, we report a case of a patient with LARC who successfully underwent a neoadjuvant treatment regimen, underwent radical surgery with preservation of the anus, a vital organ, and achieved a satisfactory pCR. The quality of life improved significantly within 16 months after ileostomy reduction, and there was no recurrence on subsequent review. We hope that this case report will provide a reference for the treatment of subsequent patients with LARC, and of course, the long-term follow-up of this patient and future large-scale clinical evidence-based studies will be the theoretical support for evaluating the effectiveness of this program.