Стратегия «Watch & Wait» в радикальном лечении рака прямой кишки: добиваемся полного ответа всеми способами?
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Ключевые слова

рак прямой кишки
неоадъювантная терапия
полный ответ опухоли
безоперационная стратегия
«смотри и жди»

Как цитировать

Самсонов, Д., Моисеенко, А. ., & Карачун , А. (2022). Стратегия «Watch & Wait» в радикальном лечении рака прямой кишки: добиваемся полного ответа всеми способами?. Вопросы онкологии, 68(5), 548–554. https://doi.org/10.37469/0507-3758-2022-68-5-548-554

Аннотация

В последнее десятилетие безоперационная тактика в отношении больных раком прямой кишки, достигших полного регресса опухоли после неоадъювантной терапии, получила широкое признание и одобрена клиническими рекомендациями ведущих онкологических организаций. Настоящая стратегия демонстрирует хорошие отдалённые результаты, подтверждающие ее безопасность. Однако отсутствие достаточного количества долгосрочных наблюдений, несовершенство методик регистрации полного клинического ответа, разногласия по поводу оптимальных сроков оценки эффекта проведенного лечения стимулируют продолжение исследований.

https://doi.org/10.37469/0507-3758-2022-68-5-548-554
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Библиографические ссылки

Gastrointestinal Tumor Study Group. Prolongation of the disease-free interval in surgically treated rectal carcinoma // N Engl J Med. 1985;312(23):1465–1472. 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;324(11):709–715. doi:10.1056/NEJM199103143241101

NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer // JAMA. 1990;264(11):1444–1450.

Sauer R, Fietkau R, Wittekind C et al. Adjuvant vs. neoadjuvant radiochemotherapy for locally advanced rectal cancer: the German trial CAO/ARO/AIO-94 // Colorectal Dis. 2003;5(5):406–415. doi:10.1046/j.1463-1318.2003.00509.x

Roh MS, Colangelo LH, O'Connell MJ et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03 // J Clin Oncol. 2009;27(31):5124–5130. doi:10.1200/JCO.2009.22.0467

Habr-Gama A, Perez RO, Nadalin W et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results // Ann Surg. 2004;240:711–717. doi:10.1097/01.sla.0000141194.27992.32

Lopez-Campos F, Martín-Martín M, Fornell-Perez R et al. Watch and wait approach in rectal cancer: Current controversies and future directions // World J Gastroenterol. 2020;26(29):4218–4239. doi:10.3748/wjg.v26.i29.4218

Lim L, Chao M, Shapiro J et al. Long-term outcomes of patients with localized rectal cancer treated with chemoradiation or radiotherapy alone because of medical inoperability or patients refusal // Dis Colon Rectum. 2007;50(12):2032–2039. doi:10.1007/s10350-007-9062-x

Habr-Gama A, São Julião GP, Vailati BB et al. Organ preservation in cT2N0 rectal cancer after neoadjuvant chemoradiation therapy: the impact of radiation therapy dose-escalation and consolidation chemotherapy // Ann Surg. 2019;269(1):102–107. doi:10.1097/SLA.0000000000002447

Appelt AL, Ploen J, Harling H et al. High-dose chemoradiotherapy and watchful waiting for distal rectal cancer: a prospective observational study // Lancet Oncol. 2015;16(8):919–927. doi:10.1016/S1470-2045(15)00120-5

Wegner RE, Hasan S, Renz PB et al. Definitive chemoradiation for rectal cancer: is there a role for dose escalation? A National Cancer Database Study // Dis Colon Rectum. 2019;62(11):1336–1343. doi:10.1097/DCR.0000000000001468

Sun Myint A, Smith FM, Gollins S et al. Dose escalation using contact X-ray brachytherapy after external beam radiotherapy as nonsurgical treatment option for rectal cancer: outcomes from a single-center experience // Int J Radiat Oncol Biol Phys. 2018;100(3):565–573. doi:10.1016/j.ijrobp.2017.10.022

Gérard JP, Barbet N, Gal J et al. Planned organ preservation for early T2–3 rectal adenocarcinoma: A French, multicentre study // Eur J Cancer. 2019;108:1–16. doi:10.1016/j.ejca.2018.11.022

Garant A, Magnan S, Devic S et al. Image guided adaptive endorectal brachytherapy in the nonoperative management of patients with rectal cancer // Int J Radiat Oncol Biol Phys. 2019;105(5):1005–1011. doi:10.1016/j.ijrobp.2019.08.042

Smith FM, Al-Amin A, Wright A et al. Contact radiotherapy boost in association with 'watch and wait' for rectal cancer: initial experience and outcomes from a shared programme between a district general hospital network and a regional oncology centre // Colorectal Dis. 2016;18(9):861–870. doi:10.1111/codi.13296

Erlandsson J, Lörinc E, Ahlberg M et al. Tumour regression after radiotherapy for rectal cancer ― Results from the randomised Stockholm III trial // Radiother Oncol. 2019;135:178–186. doi:10.1016/j.radonc.2019.03.016

Rupinski M, Szczepkowski M, Malinowska M et al. Watch and wait policy after preoperative radiotherapy for rectal cancer; management of residual lesions that appear clinically benign // EJSO. 2016;42(2):288–296. doi:10.1016/j.ejso.2015.09.022

Gerard J-P, Azria D, Gourgou-Bourgade S et al. Comparison of two neoadjuvant сhemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ACCORD 12/0405-Prodige 2 // J Clin Oncol. 2010;28(10):1638–1644. doi:10.1200/JCO.2009.25.8376

Zhu J, Liu A, Sun X et al. Multicenter, randomized, phase III trial of neoadjuvant chemoradiation with capecitabine and irinotecan guided by UGT1A1 status in patients with locally advanced rectal cancer // J Clin Oncol. 2020;38(36):4231–4239. doi:10.1200/JCO.20.01932

Bazarbashi S, Omar A, Aljubran A et al. Pre-operative chemoradiotherapy using capecitabine and cetuximab followed by definitive surgery in patients with operable rectal cancer // Hematol Oncol Stem Cell Ther. 2016;9(4):147–153. doi:10.1016/j.hemonc.2016.08.004

Salazar R, Capdevila J, Manzano JL et al. Phase II randomized trial of capecitabine with bevacizumab and external beam radiation therapy as preoperative treatment for patients with resectable locally advanced rectal adenocarcinoma: long term results // BMC Cancer. 2020;20(1):1164. doi:10.1186/s12885-020-07661-z

Garcia-Aguilar J, Chow OS, Smith DD et al. Timing of Rectal Cancer Response to Chemoradiation Consortium. Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial // Lancet Oncol. 2015;16(8):957–966. doi:10.1016/S1470-2045(15)00004-2

Fernandez-Martos C, Garcia-Albeniz X, Pericay C et al. Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial // Ann Oncol. 2015;26(8):1722–1728. doi:10.1093/annonc/mdv223

Dewdney A, Cunningham D, Tabernero J et al. Multicenter randomized phase II clinical trial comparing neoadjuvant oxaliplatin, capecitabine, and preoperative radiotherapy with or without cetuximab followed by total mesorectal excision in patients with high-risk rectal cancer (EXPERT-C) // J Clin Oncol. 2012;30(14):1620–1627. doi:10.1200/JCO.2011.39.6036

Uehara K, Hiramatsu K, Maeda A et al. Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer: N-SOG 03 phase II trial // Jpn J Clin Oncol. 2013;43(10):964–971. doi:10.1093/jjco/hyt115

Fernandez-Martos C, Brown G, Estevan R et al. Preoperative chemotherapy in patients with intermediate-risk rectal adenocarcinoma selected by high-resolution magnetic resonance imaging: the GEMCAD 0801 phase II multicenter trial // Oncologist. 2014;19(10):1042–1043. doi:10.1634/theoncologist.2014-0233/

Schrag D, Weiser MR, Goodman KA et al. Neoadjuvant chemotherapy witho ut routine use of radiation therapy for patients with locally advanced rectal cancer: a pilot trial // J Clin Oncol. 2014;32(6):513–518. doi:10.1200/JCO.2013.51.7904

Francois Y, Nemoz CJ, 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;17(8):2396–2402. doi:10.1200/JCo.1999.17.8.2396

Sloothaak DA, Geijsen DE, van Leersum NJ et al. Optimal time interval between neoadjuvant chemoradiotherapy and surgery for rectal cancer // Br J Surg. 2013;100(7):933–939. doi:10.1002/bjs.9112

Evans J, Bhoday J, Sizer B et al. Results of a prospective randomised control 6 vs 12 trial: Is greater tumour downstaging observed on post treatment MRI if surgery is delayed to 12-weeks versus 6-weeks after completion of neoadjuvant chemoradiotherapy? // Ann oncol. 2016;27(suppl. 6). doi:10.1093/annonc/mdw370.01

Lefevre JH, 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;34(31):3773–3780. doi:10.1200/JCo.2016.67.6049

Gambacorta MA, Masciocchi C, Chiloiro et al. Timing to achieve the highest rate of pCR after preoperative radiochemotherapy in rectal cancer: a pooled analysis of 3085 patients from 7 randomized trials // Radiother Oncol. 2021;154:154–160. doi:10.1016/j.radonc.2020.09.026

Dossa F, Chesney TR, Acuna SA, Baxter NN. A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis // Lancet Gastroenterol Hepatol. 2017;2(7):501–513. doi:10.1016/S2468-1253(17)30074-2

Dattani M, Heald RJ, Goussous G et al. Oncological and survival outcomes in Watch and Wait patients with a clinical complete response after neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and pooled analysis // Ann Surg. 2018;268(6):955–967. doi:10.1097/SLA.0000000000002761

Smith JJ, Strombom P, Chow OS et al. Assessment of a watch-and-wait strategy for rectal cancer in patients with a complete response after neoadjuvant therapy // JAMA Oncol. 2019;5(4):e185896. doi:10.1001/jamaoncol.2018.5896

van der Valk MJM, Hilling DE, Bastiaannet E et al. CJH IWWD Consortium. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study // Lancet. 2018;391 (10139):2537–2545. doi:10.1016/S0140-6736(18)31078-X

Habr-Gama A, Gama-Rodrigues J, São Julião GP 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;88(4):822–828. doi:10.1016/j.ijrobp.2013.12.012

Maas M, Lambregts DM, Nelemans PJ et al. Assessment of clinical complete response after chemoradiation for rectal cancer with digital rectal examination, endoscopy, and MRI: selection for organ-saving treatment // Ann Surg Oncol. 2015;22(12):3873–3880. doi:10.1245/s10434-015-4687-9

Lim SG, Kim YB, Oh SY. Clinical significance of the endoscopic finding in predicting complete tumor response to preoperative chemoradiation therapy in rectal cancer // World J Surg. 2016;40(12):3029–3034. doi:10.1007/s00268-016-3661-4

van der Sande ME, Maas M, Melenhorst J et al. Predictive value of endoscopic features for a complete response after chemoradiotherapy for rectal cancer // Ann Surg. 2021;274(6):e541–e547. doi:10.1097/SLA.0000000000003718

Kawai K, Ishihara S, Nozawa H et al. Prediction of pathological complete response using endoscopic findings and outcomes of patients who underwent watchful waiting after chemoradiotherapy for rectal cancer // Dis Colon Rectum. 2017;60(4):368–375.

de Jong EA, ten Berge JC, Dwarkasing RS et al. The accuracy of MRI, endorectal ultrasonography, and computed tomography in predicting the response of locally advanced rectal cancer after preoperative therapy: A metaanalysis // Surgery. 2016;159(3):688–699. doi:10.1016/j.surg.2015.10.019

van der Paardt MP, Zagers MB, Beets-Tan RG et al. Patients who undergo preoperative chemoradiotherapy for locally advanced rectal cancer restaged by using diagnostic MR imaging: a systematic review and meta-analysis // Radiology. 2013;269(1):101–112.

van Stiphout RG, Valentini V, Buijsen J et al. Nomogram predicting response after chemoradiotherapy in rectal cancer using sequential PET-CT imaging: a multicentric prospective study with external validation // Radiother Oncol. 2014;113(2):215–222. doi:10.1016/j.radonc.2014.11.002

Joye I, Deroose CM, Vandecaveye M, Haustermans K. The role of diffusion-weighted MRI and (18)F-FDG PET/CT in the prediction of pathologic complete response after radiochemotherapy for rectal cancer: a systematic review // Radiother Oncol. 2014;113(2):158–165. doi:10.1016/j.radonc.2014.11.026

Карачун А.М., Самсонов Д.В. Хирургическая тактика при «почти полном» ответе рака прямой кишки на неоадъювантную терапию: тотальная мезоректумэктомия или локальное иссечение? // Вопросы онкологии. 2021;67(1):40–43. doi:10.37469/0507-3758-2021-67-1-40-43 [Karachun AM, Samsonov DV. Surgical tactics in the «almost complete» response of rectal cancer to neoadjuvant therapy: total mesorectumectomy or local excision? // Voprosy onkologii. 2021;67(1):40–43 (In Russ.)]. doi:10.37469/0507-3758-2021-67-1-40-43

Lezoche E, Baldarelli M, Lezoche G et al. Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for t2 rectal cancer after neoadjuvant therapy // B J surg. 2012;99(9):1211–1218. doi:10.1002/bjs.8821

Rullier E, Vendrely V, Asselineau J et al. Organ preservation with chemoradiotherapy plus local excision for rectal cancer: 5-year results of the GRECCAR 2 randomised trial // Lancet Gastroenterol Hepatol. 2020;5(5):465–474. doi:10.1016/s2468-1253(19)30410-8

Sammour T, Price BA, Krause KJ, Chang GJ. Nonoperative management or 'Watch and Wait' for rectal cancer with complete clinical response after neoadjuvant chemoradiotherapy: a critical appraisal // Ann Surg Oncol. 2017;24(7):1904–1915. doi:10.1245/s10434-017-5841-3

Dattani M, Heald RJ, Goussous G et al. Oncological and survival outcomes in watch and wait patients with a clinical complete response after neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and pooled analysis // Ann Surg. 2018;268(6):955–967. doi:10.1097/SLA.0000000000002761

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