直肠癌氟尿嘧啶类新辅助放化疗中增加奥沙利铂对疗效的影响

摘要

1文献来源研究一:Allegra CJ,Yothers G,O’Connell MJ,et al.Neoadjuvant 5?FU or Capecitabine plus radiation with or without Oxaliplatin in rectal cancer patients:A phaseⅢrandomized clinical trial[J].J Natl Cancer Inst,2015,107(11).pii:djv:248.研究二:Azria D,Doyen J,Jarlier M,et al.Late toxicities and clinical outcome at 5 years of the ACCORD 12/0405-PRODIGE 02 trial comparing two neoadjuvant chemoradiotherapy regimens for intermediate-risk rectal cancer[J].Ann Oncol,2017,28(10):2436-2442.2证据水平研究一:1b;研究二:2a。3背景T3?4N0M0或TanyN+M0直肠癌的标准治疗是全直肠系膜切除手术(total mesorectum excision,TME),有许多临床试验评价了新辅助治疗中放疗加氟尿嘧啶类化疗治疗直肠癌的疗效,结果提示可降低局部复发率,提高局部控制,但不论术前还是术后联合应用氟尿嘧啶类为基础的化疗,均未能明显改善总生存率(overall survival,OS)。