Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press47410.17650/2686-9594-2020-10-2-42-46REVIEWОБЗОРЫ ЛИТЕРАТУРЫNeoadjuvant chemotherapy in the treatment of rectal cancer without mesorectal fascia involvement but with negative prognostic factorsНеоадъювантная химиотерапия в лечении рака прямой кишки без поражения мезоректальной фасции с негативными факторами прогнозаKochkinaS. O.КочкинаC. О.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 24

sofia.kochkina@yandex.ruGordeevS. S.ГордеевС. С.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 24

MamedliZ. Z.МамедлиЗ. З.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 24

Department of Colorectal Surgery, N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaОтделение колоректальной хирургии ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава России2908202010242462908202029082020Copyright ©; 2020, ABV-pressCopyright ©; 2020, АБВ-пресс2020ABV-pressАБВ-прессhttps://onco-surgery.info/jour/about/editorialPolicieshttps://onco-surgery.info/jour/article/view/474

This article discusses the possibility of neoadjuvant chemotherapy without radiotherapy in patients suffering from rectal cancer without mesorectal fascia involvement but with negative prognostic factors. It analyzes possible risks and benefits of such an approach and provides the data of clinical trials available so far.

В статье обсуждается возможность проведения неоадъювантной химиотерапии у больных раком прямой кишки с негативными факторами прогноза без поражения мезоректальной фасции и без использования лучевой терапии. Анализируются возможные риски и преимущества такого подхода, приводятся данные доступных клинических исследований.

rectal cancerneoadjuvant chemotherapyрак прямой кишкинеоадъювантная химиотерапияGlynne-Jones R., Wyrwicz L., Tiret E. et al. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017;28(Suppl 4):iv22–40. DOI: 10.1093/annonc/mdx224.Park I.J., You Y.N., Agarwal A. et al. Neoadjuvant treatment response as an early response indicator for patients with rectal cancer. J Clin Oncol 2012;30(15):1770–6. DOI: 10.1200/JCO.2011.39.7901.Park I.J., You Y.N., Agarwal A. et al. Neoadjuvant treatment response as an early response indicator for patients with rectal cancer. J Clin Oncol 2012;30(15):1770–6. DOI: 10.1200/JCO.2011.39.7901.Клинические рекомендации по лечению рака прямой кишки. Ассоциация онкологов России, 2020. С. 23. [Clinical guidelines for the management of rectal cancer. Association of Russian Oncologists, 2020. P. 23. (In Russ.)].NCCN Guidelines. Rectal cancer. 2020. Р. 12.NCCN Guidelines. Rectal cancer. 2020. Р. 12.Knowles G., Haigh R., McLean C. et al. Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life. Eur J Oncol Nurs 2013;17(5):570–7. DOI: 10.1016/j.ejon.2013.01.010.Knowles G., Haigh R., McLean C. et al. Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life. Eur J Oncol Nurs 2013;17(5):570–7. DOI: 10.1016/j.ejon.2013.01.010.Wiltink L.M., Chen T.Y.T., Nout R.A. et al. Health-related quality of life 14 years after preoperative short-term radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomised trial. Eur J Cancer 2014;50(14):2390–8. DOI: 10.1016/j.ejca.2014.06.020.Birgisson H., Pahlman L., Gunnarsson U., Glimelius B. Occurrence of second cancers in patients treated with radiotherapy for rectal cancer. J Clin Oncol 2005;23(25):6126–31. DOI: 10.1200/JCO.2005.02.543.Birgisson H., Pahlman L., Gunnarsson U., Glimelius B. Occurrence of second cancers in patients treated with radiotherapy for rectal cancer. J Clin Oncol 2005;23(25):6126–31. DOI: 10.1200/JCO.2005.02.543.Van Gijn W., Marijnen C.A.M., Nagtega al I.D. et al. Preoperative radiothe rapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomized controlled TME trial. Lancet Oncol 2011;12(6):575–82. DOI: 10.1016/S1470-2045(11)70097-3.Van Gijn W., Marijnen C.A.M., Nagtega al I.D. et al. Preoperative radiothe rapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomized controlled TME trial. Lancet Oncol 2011;12(6):575–82. DOI: 10.1016/S1470-2045(11)70097-3.Kapiteijn E., Marijnen C.A., Nagtegaal I.D. et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 2001;345(9):638–46. DOI: 10.1056/NEJMoa010580.Kapiteijn E., Marijnen C.A., Nagtegaal I.D. et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 2001;345(9):638–46. DOI: 10.1056/NEJMoa010580.Sauer R., Liersch T., Merkel S. et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol 2012;30(16):1926–33. DOI: 10.1200/JCO.2011.40.1836.Sebag-Montefiore D., Stephens R.J., Steele R. et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomized trial. Lancet 2009;373(9666):811–20. DOI: 10.1016/S0140-6736(09)60484-0.Abraha I., Aristei C., Palumbo I. et al. Preoperative radiotherapy and curative surgery for the management of localized rectal carcinoma. Cochrane Database Syst Rev 2018;10(10):CD002102. DOI: 10.1002/14651858.CD002102.pub3.Deng Y., Chi P., Lan P. et al. Modified FOLFOX6 with or without radiation versus uorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer: initial results of the Chinese FOWARC multicenter, open-label, randomized three-arm phase III trial. J Clin Oncol 2016;34(27):3300–7.Taylor F.G.M., Quirke P., Heald R.J. et al. Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study. Ann Surg 2011;253(4):711–9. DOI: 10.1097/SLA.0b013e31820b8d52.Mathis K.L., Larson D.W., Dozois E.J. et al. Outcomes following surgery without radiotherapy for rectal cancer. Br J Surg 2012;99(1):137–43. DOI: 10.1002/bjs.7739.Kim J.G., Song K.D., Cha D.I. et al. Indistinguishable T2/T3-N0 rectal cancer on rectal magnetic resonance imaging: comparison of surgery-first and neoadjuvant chemoradiation therapy-first strategies. Int J Colorectal Dis 2018;33(10):1359–66. DOI: 10.1007/s00384-018-3131-6.Lahaye M.J., Engelen S.M.E., Nelemans P.J. et al. Imaging for pre dicting the risk factors – the circumferen tial resection margin and nodal disease – of local recurrence in rectal cancer: a meta-analysis. Semin Ultrasound CT MR 2005;26(4):259–68. DOI: 10.1053/j.sult.2005.04.005.Al-Sukhni E., Milot L., Fruitman M. et al. Diagnostic accuracy of MRI for assessment of T category, lymph node metastases, and circumferential resection margin involvement in patients with rectal cancer: a systematic review and meta-analysis. Ann Surg Oncol 2012;19(7):2212–23. DOI: 10.1245/s10434-011-2210-5.Zhang G., Cai Y., Xu G. Diagnostic accuracy of MRI for assessment of T category and circumferential resection margin involvement in patients with rectal cancer: a meta-analysis. Dis Colon Rectum 2016;59(8):789–99. DOI: 10.1097/DCR.0000000000000611.Keane C., Young M. Accuracy of magnetic resonance imaging for preoperative staging of rectal cancer. ANZ Surg 2014;84(10):758–62.Algebally A.M., Mohey N., Szmigielski W. et al. The value of high-resolution MRI technique in patients with rectal carcinoma: pre-operative assessment of mesorectal fascia involvement, circumferential resection margin and local staging. Pol J Radiol 2015 4;80:115–21. DOI: 10.12659/PJR.892583.Haynes A.B., You Y.N., Hu C.Y. et al. Postoperative chemotherapy use after neoadjuvant chemoradiotherapy for rectal cancer: analysis of surveillance, epidemiology, and end results – medicare data, 1998–2007. Cancer 2014;120(8):1162–70. DOI: 10.1002/cncr.28545.Fernandez-Martos C., Salud A., Estevan R. Neoadjuvant capecitabine, oxliplatin, and bevacizumab (CAPOX-B) in intermediate-risk rectal cancer (RC) patients defined by magnetic resonance (MR): GEMCAD 0801 trial. J Clin Oncol 2012.Schrag D., Weiser M., Goodman K. et al. Neoadjuvant chemotherapy without routine use of radiation therapy for patients with locally advanced rectal cancer: a pilot trial. J Clin Oncol 2014;32(6):513–8. DOI: 10.1200/JCO.2013.51.7904.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):964–71.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):964–71.Nishimura J., Hasegawa J., Kato T. et al. Phase II trial of capecitabine plus oxaliplatin (CAPOX) as perioperative therapy for locally advanced rectal cancer. Cancer Chemother Pharmacol 2018;82(4):707–16. DOI: 10.1007/s00280-018-3663-z.Nishimura J., Hasegawa J., Kato T. et al. Phase II trial of capecitabine plus oxaliplatin (CAPOX) as perioperative therapy for locally advanced rectal cancer. Cancer Chemother Pharmacol 2018;82(4):707–16. DOI: 10.1007/s00280-018-3663-z.Cercek A., Weiser M., Goodman K. et al. Complete pathological response in the primary of rectal or colon cancer treated with FOLFOX without radiation. J Clin Oncol 2010;28(15S):abstr.3649.Ishii Y., Hasegawa H., Endo T. et al. Medium-term results of neoadjuvant systemic chemotherapy using irinotecan, 5-fluorouracil, and leucovorin in patients with locally advanced rectal cancer. Eur J Surg Oncol 2010;36(11):1061–5. DOI: 10.1016/j.ejso.2010.05.017.Ishii Y., Hasegawa H., Endo T. et al. Medium-term results of neoadjuvant systemic chemotherapy using irinotecan, 5-fluorouracil, and leucovorin in patients with locally advanced rectal cancer. Eur J Surg Oncol 2010;36(11):1061–5. DOI: 10.1016/j.ejso.2010.05.017.Hasegawa J., Tsunekazu M., Ho M.K. et al. Neoadjuvant capecitabine and oxaliplatin (XELOX) with bevacizumab for locally advanced rectal cancer. J Clin Oncol 2013;31(4 Suppl):abstr.566.Seymour M.T., Morton D., International FOXTROT Trial Investigators. FOXTROT: an international randomized controlled trial in 1052 patients (pts) evaluating neoadjuvant chemotherapy (NAC) for colon cancer. J Clin Oncol 2019;37(15 Suppl):3504.Ohwada S., Sato Y., Izumi M. et al. Preoperative tegafur suppositories for resectable rectal cancer: phase II trial. Dis Colon Rectum 2005;49(10):1602–10. DOI: 10.1007/s10350-006-0612-4.