Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press2810.17650/2220-3478-2012-0-1-7-10IN FOCUSВ ЦЕНТРЕ ВНИМАНИЯMULTIDISCIPLINARY TREATMENT OF RECTAL CANCER: THE ASSESSMENT OF CLINICAL AND PATHOLOGIC RESPONSE FOR LOCALLY ADVANCED RECTAL CANCER TREATED WITH NEOADJUVANT CHEMORADIOTHERAPYМУЛЬТИДИСЦИПЛИНАРНЫЙ ПОДХОД К ЛЕЧЕНИЮ БОЛЬНЫХ РАКОМ ПРЯМОЙ КИШКИ: ОЦЕНКА КЛИНИЧЕСКОГО И ПАТОЛОГИЧЕСКОГО ОТВЕТА У БОЛЬНЫХ, ПОЛУЧАВШИХ ПРЕДОПЕРАЦИОННУЮ ХИМИОЛУЧЕВУЮ ТЕРАПИЮPravosudovI. V.ПравосудовИ. В.
Russian Federation
pravosudov@rambler.ruAliyevI. I.АлиевИ. И.
Russian Federation
ShulepovA. V.ШулеповА. В.
Russian Federation
KrzhivitskyP. I.КрживицкийП. И.
Russian Federation
N.N. Petrov Research Institute of Oncology, Ministry of Health and Social Development of Russia, Saint PetersburgФГБУ НИИ онкологии им. Н.Н. Петрова Минздравсоцразвития России, Санкт-Петербург26022012117102602201526022015Copyright ©; 2012, ABV-pressCopyright ©; 2012, АБВ-пресс2012ABV-pressАБВ-прессhttps://onco-surgery.info/jour/about/editorialPolicieshttps://onco-surgery.info/jour/article/view/28

Preoperative staging by digital examination, endorectal ultrasound and magnetic resonance imaging (MRI) allows an assessment of the risk of local recurrence after surgery alone. The successful management of rectal cancer requires a multidisciplinary approach, with treatment decisions based on precise patient evaluations. Chemoradiotherapy (CRT) is associated with reduction of tumor size and downstaging.The aim of this study is to assess how often complete clinical response is achieved after eoadjuvant CRT and its concordance with pathologic complete response.Results. Patients with biopsy-proven, locally advanced rectal cancer (T3, T4) were treated by CRT followed by radical surgery. Tumors were re-assessed after 8 weeks from CRT completion using MRI and endoscopic examination. The results of examination were comparedwith the final histopathologic status.Conclusions. Neoadjuvant CRT leads to significant tumor regression and in some patients there is complete disappearance of neoplasm. MRI combining with colonoscopic findings is a useful tool to evaluate these features.

Предоперационное стадирование с использованием инструментальных методов диагностики: эндоректальной ультрасонографии и магнитно-резонансной томографии (МРТ) позволяет оценить риск развития местного рецидива после хирургического лечения рака прямой кишки (РПК).Успешное лечение РПК требует мультидисциплинарного подхода, использования химиолучевой терапии (ХЛТ).Цель исследования: оценить, как часто достигается полный клинический ответ после неоадъювантной ХЛТ и каково его соотношение с полным патологическим регрессом.Результаты. Пациенты с местно-распространенным РПК (T3, T4), морфологически подтвержденным, подвергались ХЛТ с последующей радикальной операцией. Оценка эффекта производилась через 8 нед после завершения ХЛТ с помощью МРТ и эндоскопического исследования. Результаты сравнивались с окончательным гистологическим заключением.Выводы. Неоадъювантная ХЛТ приводит к существенному регрессу опухоли, а у некоторых пациентов к ее полному исчезновению. МРТ вместе с фиброколоноскопией позволяют оценить эффект лечения.

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