【摘要】 本文分享1例直肠癌患者的多学科团队(MDT)诊治经过。首次MDT后,该患者诊断为直肠癌伴腹股沟淋巴结转移(cT4bN1M1),采用XELOX方案全身化疗同步直肠瘤区及腹股沟引流区局部放疗。放疗后15周MDT评估直肠原发灶明显退缩,临床完全缓解(cCR)可能,却新发肝内单发转移灶。进一步MDT建议行肝转移灶局部射频消融术。术后肿瘤标志物、肝脏MRI、PETCT等多种手段提示患者达到无瘤状态,目前临床密切随访中。对于接受新辅助放化疗后直肠原发灶cCR的患者,根治性手术和等待观察策略如何选择是值得进一步思考的问题。更多还原

【Abstract】 This case report described the process of a rectal cancer patient managed by multidisciplinary team(MDT). The patient was diagnosed as rectal cancer with inguinal lymph nodes metastasis(cT4 bN1 M1) after initial MDT evaluation. The patient received concurrent XELOX chemotherapy plus local radiotherapy to primary tumor and groin drainage area. The primary lesion was re-evaluated in fifteen weeks post radiation. It was shrinked dramatically and that clinical complete remission(cCR) can not be ruled out. However, a single liver metastatic lesion was newly detected. After further MDT discussion, radiofrequency ablation(RFA) for the liver metastasis was recommended and delivered to the patient. Multiple methods including tumor biomarkers, hepatic MRI and PET-CT showed no evidence of disease in the patient after RFA. The patient is in routine follow-up now. For these rectal cancer patients which achieved cCR in primary lesion after neo-adjuvant chemoradiotherapy, the following decision of radical resection or wait and watch strategy is worthy of further consideration.更多还原