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目前基于氟尿嘧啶及卡培他滨的术前同步放化疗是局部进展期直肠癌的标准治疗模式,但仍有较高的远处转移率,为进一步提高疗效,探索新的化疗药物越来越受到学界的重视。其中奥沙利铂因其在辅助化疗及姑息治疗中的效果卓越,受到越来越多学者的关注,并因此开展了一系列Ⅰ~Ⅲ期临床研究。绝大多数Ⅰ/Ⅱ期临床研究表明奥沙利铂具有很好的应用前景,不仅达到良好病理完全缓解(p CR)率及肿瘤降期率,且不良反应可耐受。但是,在Ⅲ期临床研究中,STAR-01、ACCORD-12、NSABP-R04、PETACC-6均为阴性结果,仅CAO/ARO/AIO-04是阳性结果 ,显示奥沙利铂组能够获得显著的总生存期(DFS)获益,故奥沙利铂能否应用于局部进展期直肠癌术前放化疗存在明显的争议。因此根据目前研究结果,在直肠癌术前新辅助放化疗中,仍然不推荐在5-Fu/卡培他滨基础上常规使用奥沙利铂。全文对奥沙利铂在局部进展期直肠癌术前同步放化疗中的应用进行了总结,希望为进一步的临床研究提供依据。
At present, preoperative chemoradiation based on fluorouracil and capecitabine is the standard treatment for locally advanced rectal cancer, but there is still a high rate of distant metastasis. To further improve the curative effect, more and more new chemotherapeutic agents are explored Academic attention. Among them, oxaliplatin has attracted more and more scholars’ attention because of its excellent effect in adjuvant chemotherapy and palliative treatment. Therefore, a series of Phase I-III clinical studies have been carried out. Most phase Ⅰ / Ⅱ clinical studies have shown that oxaliplatin has a good prospect, not only to achieve a good pathological complete remission (pCR) rate and tumor down rate, and adverse reactions can be tolerated. However, STAR-01, ACCORD-12, NSABP-R04, and PETACC-6 were all negative results in the phase III clinical trial, with CAO / ARO / AIO-04 alone being positive, indicating significant gains in the oxaliplatin group Of the total survival (DFS) benefit, so whether the application of oxaliplatin in locally advanced rectal cancer preoperative radiotherapy there is a clear controversy. Therefore, according to the results of the present study, oxaliplatin is still not recommended for 5-Fu / capecitabine preoperative neoadjuvant chemoradiation. The paper summarizes the application of oxaliplatin in preoperative concurrent chemoradiotherapy of locally advanced rectal cancer, hoping to provide the basis for further clinical research.