Аннотация
В настоящее время комбинированная терапия, включающая предоперационное облучение опухоли и зон регионарного лимфо-оттока, стала стандартом лечения больных местнораспространенным раком прямой кишки. Методы оценки интенсивности ответа опухоли на неоадъювантной терапию все шире внедряются в практику специализированных медицинских центров. Однако прогностическое значение выраженности регресса опухоли остается неясным. Результаты многочисленных исследований, представленных в современной литературе, разноречивы, а сравнительный анализ их крайне сложен из-за обилия используемых классификаций постлучевого регресса. В данной обзорной статье отражены современные представления о роли и способах оценки лечебного патоморфоза рака прямой кишки после лучевой/химиолучевой терапии.
Библиографические ссылки
Fokas Е., Liersch Т., Fietkau R. et al. Tumor regression grading after preoperative chemoradiotherapy for locally advanced rectal carcinoma revisited: updated results of the CAO/ARO/AIO-94 trial // J. Clin. Oncol. - 2014. - Vol. 32(15). - P. 1554-1562. - 10.1200/ JC0.2013.54.3769. DOI: 10.1200/JC0.2013.54.3769
Rodel C., Hofheinz R., Liersch T. Rectal cancer: state of the art in 2012 // Curr. Opin. Oncol. - 2012. - Vol. 24(4). - P. 441-447. - DOI: 10.1097/CC0.0b013e328352ea02
Злокачественные новообразования в России в 2016 году. / Под ред. Каприна А.Д., Старинского В.В., Петровой Г.В. - М.: МНИОИ им. П.А. Герцена - филиал ФГБУ «НМИЦ радиологии» Минздрава России; 2018.
Gastrointestinal Tumor Study Group. Prolongation of the disease-free interval in surgically treated rectal carcinoma // N. Engl. J. Med. - 1985. - Vol. 312(23). - P. 1465-1472. - 10.1056/ NEJM198506063122301. DOI: 10.1056/NEJM198506063122301
Krook JE, Moertel CG, Gunderson LL et al. Effective surgical adjuvant therapy for high-risk rectal carcinoma // N. Engl. J. Med. - 1991. - Vol. 324(11). - P. 709715. - DOI: 10.1056/NEJM199103143241101
NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer // JAMA. - 1990. - Vol. 264(11). - P. 1444-1450.
Беляев А.М., Алиев И.И., Карачун А.М., Самсонов Д.В. Значение лучевой терапии в комбинированном лечении рака прямой кишки (обзор литературы) // Колопроктология. - 2012. - Т. 42. - № 4 - С. 3339.
Sauer R., Becker H., Hohenberger W. et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer // N. Engl. J. Med. - 2004. - Vol. 351(17). - P. 17311740. DOI: 10.1056/NEJMoa040694
Watanabe T., Muro K., Ajioka Y. et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer // Int. J. Clin. Oncol. -2018. - Vol. 23(1). - P. 1-34. - 10.1007/ s10147-017-1101-6. DOI: 10.1007/s10147-017-1101-6
Грабовой А.Н., Тарасова Т.А., Кошубарова М.В. Гистологическая оценка ответа опухоли на химио-/ лучевую терапию // Клиническая онкология. - 2012. - T. 2. - № 6. - С. 138-143.
Mandard A.M., Dalibard F., Mandard J.C. et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma Clinicopathologic. Correlations // Cancer. - 1994. - Vol. 73(11). - P. 2680-2686.
Dworak O., Keilholz L., Hoffmann A. Pathological features of rectal cancer after preoperative radiochemotherapy // Int. J. Colorectal. Dis. - 1997. - Vol. 12(1). - P. 19
Rodel C., Martus P., Papadoupolos T. et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer // J. Clin. Oncol. -2005. - Vol. 23(34). - P. 8688-8696. - 10.1200/ JC0.2005.02.1329. DOI: 10.1200/JC0.2005.02.1329
Wheeler J.M.D., Warren B.F., Mortensen NJMcC. et al. Quantification of histologic regression of rectal cancer after irradiation. A proposal for a modified staging system // Dis Colon Rectum. - 2002. - Vol. 45(8). - P. 1051-1056.
Williams G.T., Quirke P., Shepherd N.A. Dataset for colorectal cancer. 2nd ed. London: The Royal College of Pathologists, 2008.
Ryan R., Gibbons D., Hyland J.M. et al. Pathological response following long-course neoadjuvant chemora-diotherapy for locally advanced rectal cancer // Histo-pathology. -2005. - Vol. 47(2). - P. 141-146. - DOI: 10.1111/j.1365-2559.2005.02176.x
Quah HM, Chou JF, Gonen M. et al. Pathologic stage is most prognostic of disease-free survival in locally ad vanced rectal Cancer patients after preoperative chemo-radiation // Cancer. - 2008. - Vol. 113(1). - P. 5764. - DOI: 10.1002/cncr.23516
Edge S.B., Byrd D.R., Compton C.C. et al., editors. AJCC cancer staging manual. 7th ed. New York: Springer-Verlag, 2010.
Bateman AC, Jaynes E., Bateman AR Rectal cancer staging post neoadjuvant therapy - how should the changes be assessed? // Histopathology. - 2009. - Vol. 54(6). - P. 713-721. - DOI: 10.1111/j.1365-2559.2009.03292.x
Kim SH, Chang HJ, Kim DY et al. What is the ideal tumor regression grading system in rectal cancer patients after preoperative chemoradiotherapy? // Cancer Res Treat. - 2016. - Vol. 48(3). - P. 998-1009. - 10.4143/ crt.2015.254. DOI: 10.4143/crt.2015.254
Trakarnsanga A., Gonen M., Shia J. et al. Comparison of tumor regression grade systems for locally advanced rectal cancer after multimodality treatment // J. Natl. Cancer Inst. -2014. - Vol. 106(10). - dju248. DOI: 10.1093/jnci/
van der Paardt M.P., Zagers M.B., Beets-Tan R.G. et al. Patients who undergo preoperative chemoradiotherapy for locally advanced rectal cancer restaged by using diagnostic MR imaging: a systematic review and metaanalysis // Radiology. - 2013. - Vol. 269(1). - P. 101112. - DOI: 10.1148/radiol.13122833
Yeo S.G., Kim D.Y., Kim T.H. et al. Tumor volume reduction rate measured by magnetic resonance volumetry correlated with pathologic tumor response of preoperative chemoradiotherapy for rectal cancer // Int. J. Radiat. Oncol. Biol. Phys. - 2010. - Vol. 78(1). - P. 164-171. - DOI: 10.1016/j.ijrobp.2009.07.1682
Patel UB, Brown G. MRI-Based Assessment of Tumor Regression in Rectal Cancer // Curr. Colorectal. Cancer Rep. - 2013. - Vol. 9(2). - P. 136-145. - DOI: 10.1007/s11888-013-0169-2
Patel U.B., Taylor F., Blomqvist L. et al. Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience // J. Clin. Oncol. - 2011. - Vol. 29(28). - P. 3753-3760. - DOI: 10.1200/Jm.2011.34.9068
Patel U.B., Brown G., Rutten H. et al. Comparison of magnetic resonance imaging and histopathological response to chemoradiotherapy in locally advanced rectal cancer // Ann. Surg. Oncol. - 2012. - Vol. 19(9). - P. 2842-2852. - DOI: 10.1245/s10434-012-2309-3
Sassen S., de Booij M., Sosef M. et al. Locally advanced rectal cancer: is diffusion weighted MRI helpful for the identification of complete responders (ypT0N0) after neoadjuvant chemoradiation therapy? // Eur Radiol. - 2013. - Vol. 23(12). - P. 3440-3449. - 10.1007/ s00330-013-2956-1. DOI: 10.1007/s00330-013-2956-1
Francois Y., Nemoz C.J., Baulieux J. et al. Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer: the Lyon R90-01 randomized trial // J. Clin. Oncol. - 1999. - Vol. 17(8). - P. 23962402. - DOI: 10.1200/Jm.1999.17.8.2396
Sloothaak D.A., Geijsen D.E., van Leersum N.J. et al. Optimal time interval between neoadjuvant chemoradiotherapy and surgery for rectal cancer // Br. J. Surg. - 2013. - Vol. 100(7). - P. 933-939. - 10.1002/ bjs.9112. DOI: 10.1002/bjs.9112
Macchia G., Gambacorta M.A., Masciocchi C. et al. 40 Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients // Clin. Transl. Radiat. Oncol. - 2017. - Vol. 4. - P. 8-14. - 10.1016/j. ctro.2017.04.004. DOI: 10.1016/j.ctro.2017.04.004
Evans J., Bhoday J., Sizer B. et al. Results of a prospective randomised control 6 vs 12 trial: Is greater tumour 41 downstaging observed on post treatment MRI if surgery is delayed to 12-weeks versus 6-weeks after completion of neoadjuvant chemoradiotherapy? // Ann. Oncol. - 2016. - Vol. 27 (Suppl 6). - mdw370.01. 42 DOI: 10.1093/annonc/
Lefevre J.H., Mineur L., Kotti S. et al. Effect of interval (7 or 11 weeks) between neoadjuvant radiochemotherapy and surgery on complete pathologic response in rectal cancer: a multicenter, randomized, controlled trial (GRECCAR-6) // J. Clin. Oncol. - 2016. - Vol. 34(31). - P. 3773-3780. - 10.1200/ 43 JCO.2016.67.6049 DOI: 10.1200/43JCO.2016.67.6049
Park MJ, Kim SH, Lee SJ et al. Locally advanced rectal cancer: added value of diffusion-weighted MR imaging for predicting tumor clearance of the mesorectal fascia after neoadjuvant chemotherapy and radiation therapy // Radiology. - 2011. - Vol. 260(3). - P. 771-780. - 44 DOI: 10.1148/radiol.11102135
Карачун А.М., Синенченко Г.И., Самсонов Д.В., Алиев И.И. Полный патоморфологический ответ на неоадъювантную терапию и его роль в стратегии лечения рака прямой кишки // онкологическая колопроктология. - 2013. - № 3 - С. 25-29.
Capirci C., Valentini V., Cionini L. et al. Prognostic value of pathologic complete response after neoadjuvant therapy in locally advanced rectal cancer: long-term analysis of 566 ypCR patients // Int. J. Radiat. Oncol. Biol. Phys. - 47 2008. - Vol. 72(1). - P. 99-107. - 10.1016/j. ijrobp.2007.12.019 DOI: 10.1016/j.ijrobp.2007.12.019
Maas M., Nelemans P.J., Valentini V. et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled 48. analysis of individual patient data // Lancet Oncol. - 2010. - Vol. 11(9). - P. 835-844. - 10.1016/ S1470-2045(10)70172-8 DOI: 10.1016/S1470-2045
Martin ST, Heneghan HM, Winter DC. Systematic review and meta-analysis of outcomes following pathological complete response to neoadjuvant chemoradiotherapy for rectal cancer // Br. J. Surg. - 2012. - Vol. 99(7). - P. 918-928. - DOI: 10.1002/bjs.8702
Omejc M, Potisek M. Prognostic significance of tumor regression in locally advanced rectal cancer after preoperative radiochemotherapy // Radiol. Oncol. - 2017. - Vol. 52(1). - P. 30-35. - DOI: 10.1515/raon-2017-0059
Stipa F, Chessin DB, Shia J et al. A pathologic complete response of rectal cancer to preoperative combined-mo-dality therapy results in improved oncological outcome compared with those who achieve no downstaging on the basis of preoperative endorectal ultrasonography // Ann Surg. Oncol. - 2006. - Vol. 13(8). - P. 1047-1053. - DOI: 10.1245/ASO.2006.03.053
Habr-Gama A., Gama-Rodrigues J., Sao Juliao G.P. et al. Local recurrence after complete clinical response and watch and wait in rectal cancer after neoadjuvant chemoradiation: impact of salvage therapy on local disease control // Int. J. Radiat. Oncol. Biol. Phys. -2014. - Vol. 88(4). - P. 822-828. - 10.1016/j. ijrobp.2013.12.012 DOI: 10.1016/j.ijrobp.2013.12.012
Santos M.D., Silva C., Rocha A. et al. Prognostic value of Mandard and Dworak tumor regression grading in rectal cancer: study of a single tertiary center // ISRN Surg. -2014. - Vol. 2014. - P. 310542. - DOI: 10.1155/2014/310542
Suarez J.., Vera R, Balen E. et al. Pathologic response assessed by Mandard grade is a better prognostic factor than down staging for disease-free survival after preoperative radiochemotherapy for advanced rectal cancer // Colorectal Dis. - 2008. - Vol. 10(6). - P. 563-568. - DOI: 10.1111/j.1463-1318.2007.01424.x
Zhang L.N., Xiao W.W., Xi S.Y et al. Pathological assessment of the AJCC tumor regression grading system after preoperative chemoradiotherapy for chinese locally advanced rectal cancer // Medicine (Baltimore). - 2016. - Vol. 95(3). - P. e2272. - 10.1097/ MD.0000000000002272 DOI: 10.1097/MD.0000000000002272
Suzuki T, Sadahiro S., Tanaka A. et al. A modified classification of prognostic factors based on pathological stage and tumor regression grade in patients with rectal cancer who receive preoperative chemoradiotherapy // Oncology. - 2017. - Vol. 93(5). - P. 287-294. - DOI: 10.1159/000478266
Ruo L., Tickoo S., Klimstra D.S. et al. Long-term prognostic significance of extent of rectal cancer response to preoperative radiation and chemotherapy // Ann. Surg. -2002. - Vol. 236(1). - P. 75-81
Shia J., Guillem J.G., Moore H.G. et al. Patterns of morphologic alteration in residual rectal carcinoma following preoperative chemoradiation and their association with long-term outcome // Am. J. Surg. Pathol. - 2004. - Vol. 28(2). - P. 215-223
Colorectal Cancer Collaborative Group. Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials // Lancet. - 2001. - Vol. 358(9290). - P. 1291-1304. - DOI: 10.1016/S0140-6736(01)06409-1
Munro A.J., Bentley A.H.M. Adjuvant radiotherapy in operable rectal cancer: a systematic review // Semin Colon Rectal. Surg. - 2002. - Vol. 13(1). - P. 31-42
Wong R.K., Tandan V., De Silva S., Figueredo A. Pre-operative radiotherapy and curative surgery for the management of localized rectal carcinoma // Cochrane Database Syst. Rev. - 2007. - Vol. (2). - P. CD002102. - DOI: 10.1002/14651858.CD002102.pub2
Swedish Rectal Cancer Trial. Improved survival with preoperative radiotherapy in resectable rectal cancer // N. Engl. J. Med. - 1997. - Vol. 336(14). - P. 980-987. - DOI: 10.1056/NEJM199704033361402
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