Изменения в клинических рекомендациях по лечению колоректального рака в 2024 году

Цель исследования – обеспечение возможности более широкого обсуждения изменений в клинических рекомендациях до их официального внедрения в клиническую практику.

Материалы и методы. Представлены краткий обзор литературы и обоснование каждого предлагаемого крупного изменения в разделе лечения. Обсуждается отказ от проведения предоперационной лучевой терапии при раке верхнеампулярного отдела прямой кишки, сужение показаний к предоперационной лучевой терапии при раке среднеампулярного отдела прямой кишки, а также расширение показаний к проведению тотальной неаоадъювантной химиотерапии при раке прямой кишки с поражением циркулярной границы резекции. Обсуждаются изменения в разделе лекарственного лечения.

Результаты. В данной статье представлены планируемые изменения клинических рекомендаций по лечению неметастатического рака ободочной и прямой кишки в 2024 году. Ключевые изменения коснулись предоперационного лечения рака прямой кишки, предложен ряд изменений в разделе адъювантного лечения рака ободочной кишки. Предложен новый алгоритм выбора метода предоперационного лечения рака прямой кишки с учетом индивидуальных особенностей пациента.

Выводы. Достигнут консенсус о необходимости расширения показаний к проведению неоадъювантной химиотерапии, однако только у пациентов с высоким функциональным статусом. Наибольшее преимущество могут получить пациенты, когда целью лечения является достижение полного клинического ответа на лечение, и пациенты с исходным поражением циркулярной границы резекции.

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