Химиолучевая терапия локализованного колоректального рака: взгляд со стороны

Введение. Колоректальный рак занимает лидирующие позиции по заболеваемости и смертности от злокачественных опухолей. Выбор вектора терапии локализованного колоректального рака вызывает много дискуссий. Хирургическая резекция прямой кишки, такая как ТМЭ, обычно связана с высоким уровнем послеоперационных осложнений и летальностью. Потенциально интеграция различных вариантов химиотерапии в стандартное лечение локализованного рака прямой кишки может усилить контроль над опухолью с последующим снижением частоты рецидивов и, следовательно, повысить общую и безрецидивную выживаемость. Более того, есть категории пациентов, которым противопоказано оперативное лечение, и для них будет полезнее химиотерапевтический подход. Определенный режим лечения для пациентов пожилого возраста, имеющих отягощенный анамнез, с этим видом рака еще не сформирован, несмотря на то, что средний возраст установления диагноза колоректального рака составляет около 70 лет. Оптимальные рекомендации по лечению этой группы пациентов еще не консолидированы, поэтому этот вопрос остается предметом дискуссий.

Цель исследования. Мы рассмотрели альтернативные подходы к терапии локализованного рака прямой кишки и ведению особых групп пациентов с этим диагнозом.

Материал и методы. Проведен поиск публикаций в базах данных Pubmed, eLibrary, а также поиск актуальной информации на базе мировых онкологических ассоциаций.

Выводы. Сравнивая хирургический подход и химиолучевую терапию у пациентов с локализованным раком прямой кишки, отмечено, что в некоторых случаях неоадъювантная терапия может быть полезной, выступая в качестве идеальной альтернативы. Однако такой подход может подойти только для определенных групп пациентов. Кроме того, наблюдение после лечения также должно включать строгий перечень диагностических процедур. 

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