The Research Progress Of Rectal Cancer Neoadjuvant Therapy

Colorectal cancer is one of the more common gastrointestinal malignancy,and is the word's first third largest cancer,its cancer-related mortality among the first four in malignant tumors.The incidence of colorectal cancer in China growth of 4.2% per year on average,10% to 15% of all malignant tumor.At present the treatment of main measures is surgical treatment,early rectal cancer curative effect is significantly,the recurrence rate is low.However,the incidence of rectal cancer differ from other regions in China:the onset age,the low rectal cancer is higher,the higher the degree of malignancy is more common in poorly differentiated,more common in patients with advanced.Therefore,surgery alone can not effectively cut small lesions leading to higher rates of colorectal cancer postoperative local recurrence and distant metastasis rate,which is the main cause of treatment failure.In recent years,themulti-disciplinary comprehensive treatment can make benefits patients with rectal cancer,more and more treatment options applied to the treatment.Before the 1980 s of neoadjuvant chemotherapy in particular caught attention of clinicians,radiotherapy,chemotherapy and chemotherapy combined with radiotherapy include neoadjuvant therapy,which can reduce tumor stage,remove tumor small lesions,improve the resection rate,thereby reducing the recurrence improving patient survival.The correct preoperative evaluation is the foundation of neoadjuvant therapy application,Currently used TNM clinical staging,through the rectal endoscopic ultrasound and MRI staging,in2011,NCCN guidelines consider any T,N1-2 and T3,N0,and T4 and locally unresectable rectal cancer requires neoadjuvant treatment,stage I rectal cancer should not be given in addition to surgery than the other,because of its low rate of recurrence and can not benefit from the new adjuvant therapy.Medicament for neoadjuvant chemotherapy fluorouracil,oxaliplatin,capecitabine and irinotecan,are generally not in favor of multi-drug chemotherapy regimens for neoadjuvant therapy,Neoadjuvant chemoradiation plan has movers radiotherapy and long-course radiotherapy.Neoadjuvant therapy while improving patient survival also increased adverse treatment,which requires its efficacy evaluation,research shows that,for advanced rectal cancer,and recurrence after neoadjuvant therapy relative to reduced tumor,lymph nodes and small vessels.This review aims to introduce rectal cancer neoadjuvant therapy recent advances in clinical application.