Журнал «Практическая онкология» Том 6, №1, 2023

Колоректальний рак є другою за поширеністю локалізацією раку як серед чоловіків, так і серед жінок в Україні. Основним способом рецидиву раку прямої кишки є віддалене метастазування. Крім того, хірургічне лікування часом передбачає постійну колостомію, а також супроводжується певною частотою статевої та сечовидільної дисфункції. Ці фактори спонукають до пошуку кращих стратегій лікування, й однією з них може бути інтенсифікація передопераційної терапії. В огляді наведені результати тотальної неоад’ювантної терапії, яка являє собою поєднання хіміотерапії на основі оксаліплатину з довготривалою хіміопроменевою терапією або короткотривалою променевою терапією. Успіхи передопераційних методів лікування призвели до можливості розгляду неоперативного лікування як одного з варіантів подальшого ведення пацієнтів. У той же час актуальності набуває неоад’ювантна імунотерапія, оскільки таким чином можна досягти сильнішої імунної відповіді. Хоч поки що такий підхід не вважається стандартним, ранні результати низки досліджень у цій сфері є багатообіцяючими.

Colorectal cancer is the second most common cancer localization among both men and women in Ukraine. The main way of recurrence of rectal cancer is distant metastasis. In addition, surgical treatment sometimes involves a permanent colostomy and is also accompanied by a certain incidence of sexual and urinary dysfunction. These factors encourage searching for better treatment strategies and one of them may be the intensification of preoperative therapy. The review presents the results of total neoadjuvant therapy, which is a combination of oxaliplatin-based chemotherapy with long-course chemoradiation or short-course radiotherapy. The success of preoperative treatment methods has led to the possibility of considering non-operative treatment as one of the options for further management of patients. At the same time, neoadjuvant immunotherapy is becoming relevant as a possible way to achieve a stronger immune response. Although this approach isn’t yet considered standard, the early results of studies in this area are promising.

тотальна неоад’ювантна терапія; індукційна хіміотерапія; консолідаційна хіміотерапія; стратегія «спостерігати і чекати»; неоад’ювантна імунотерапія

total neoadjuvant therapy; induction chemotherapy; consolidation chemotherapy; watch-and-wait strategy; neoadjuvant immunotherapy

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