The treatment of rectal cancer

Rectal cancer treatment includes both traditional Western medicine surgery, radiotherapy and chemotherapy, and traditional Chinese medicine check against therapy, but also including emerging molecular targeted therapy and gene therapy, the current cancer treatment is still mainly based on surgery, complemented by integrated traditional Chinese medicine treatment, about half of cancer patients treated with surgery, the cause of death is metastasis and recurrence, using Chinese medicine, radiotherapy and chemotherapy and so persist in consolidation therapy after surgery significantly reduced mortality, the emerging cancer treatment can be the circumstances under which the traditional method does not work can also be used in conjunction with the traditional method, the following summarized as follows:

1, rectal cancer surgery

Surgical treatment of rectal cancer surgery is the first stress and focus on combined preoperative chemotherapy, radiotherapy, combined therapy such as Chinese medicine to improve the surgical resection rate and decrease the recurrence rate after surgery and improve survival. Principles of surgical treatment of rectal cancer are: (1) as radical; (2) best to protect the pelvic autonomic nerves, preservation of patients with sexual function, urinary function and bowel function, as far as possible preservation of anal sphincter, improve quality of life.

Surgical treatment of colorectal liver metastases, surgical resection of colorectal liver metastasis can still be effective, many studies have confirmed that the 5-year survival rate was 25% ~ 35%, its 10-year survival rate of 20% of the total The median survival time of 28 ~ 40 months after resection of hepatic metastasis in patients with recurrence could be re-operation. Studies have reported 64 cases, again 5-year survival rate after surgery is 41%. Therefore, unless there is an absolute contraindication, all patients with colorectal liver metastases, if metastases can be removed, surgery should be considered. For patients with unresectable hepatic metastasis, or surgical margin after resection of primary tumors have more residual or residual small foci, can be used Chinese medicine, refrigeration, radio frequency, via hepatic artery infusion chemotherapy and other treatment, a part of unresectable patients can switch to treatment for resectable.

2, cancer chemotherapy,

About half of patients with colorectal cancer metastasis and recurrence after surgery occurred, in addition to some early patients, the late and surgical resection in patients receiving chemotherapy required. Combined treatment with chemotherapy in colorectal cancer is surgical treatment, except after a major therapeutic measures.

Systemic chemotherapy combined with intravenous chemotherapy in colorectal cancer mainly 5-FU-based tetrahydrofolate (LV) as a reconciling agent can enhance the effects of dose 5 - FU efficacy. 5-FU/LV combination therapy whose efficacy has been confirmed that the majority of the Institute is the worldwide standard of care at the present stage.

3, rectal cancer radiation therapy

Applies only to cancer of the rectum. Preoperative radiotherapy has not been due to surgical damage to local blood supply and oxygen conditions were better, resulting in iatrogenic chances of proliferation or the transfer of small and therefore I believe that a more favorable preoperative radiotherapy can play a down period and reduce the bleeding of the effect. Postoperative radiotherapy due to staging and reasonable, so that more selective postoperative radiotherapy to reduce preoperative radiotherapy in the treatment of blindness and load.

4, biological and immunotherapy

Biological treatment is a supplement from the in vitro, induced or activated in vivo biological response modifiers have been inherent in the system with cell activity and (or) factor, to regulate such a response. There are many scholars reported that tumor-infiltrating lymphocytes (tu-mor-infiltratinglymphocytes, TIL) in vitro can be separated from the tumor to develop amplification, and has in vitro specificity in vitro. Interleukin -2 (IL-2) be able to lift the state of TIL's incompetence, and can promote antigen-presenting and T-cell response. Chemotherapy can increase tumor TIL to gather oriented to increase the TIL destruction of tumor cells. Zhou Qingxian such reports 54 cases of Dukes C rectal cancer patients underwent radical surgery, using prospective randomized approach, the use of TIL immunotherapy plus chemotherapy in rectal cancer patients after, another group using the same regimen as the control group . The results showed that the use of TIL, the immune function significantly improved compared with the control group (P <0.05),> 0.05). 3 year local recurrence rate decreased significantly (P <0.05). The results suggest that in patients with advanced rectal cancer after radical resection, the use of TIL immunotherapy is effective, is expected to become important for advanced rectal cancer patients after treatment.

5, gene therapy

The so-called cancer gene therapy is the application of genetic engineering calibration or repair and tumor-related genetic variation, or by changing the biological characteristics of certain cells and enhance the host's resistance to diseases, so as to achieve the purpose of treatment of cancer of a class method. The occurrence of rectal cancer is a combination of genetic and environmental factors result of the interaction. Gene therapy for colorectal cancer there are many ways. To sum up can be divided into the following four categories: (1) suicide gene therapy; (2) for the proto-oncogenes and tumor suppressor gene therapy; (3) immuno-gene therapy; (4) a variety of gene therapy.

Gene therapy, the key is how the exogenous gene into the corresponding target cells and have access to safe and effective expression. Now commonly used gene transfer methods can be divided into two categories: those with the virus as a carrier-mediated method, and the other non-viral vector-mediated.

Gene therapy is still primarily in the experimental study phase, a number of ways to enter clinical trials, with the key technologies and the gradual resolution of a number of issues, cancer gene therapy will become an important means of treating cancer.

6. A comprehensive treatment combined Chinese and Western Medicine

Treatment of TCM and Western medicine has become China's advanced rectal cancer, especially in the treatment of the major form of integrative medicine in clinical practice, diagnostic classification of traditional Chinese medicine with modern medical instruments, has increased from a simple empirical science to the objective of and standardized the development of modern Chinese medicine, Chinese medicine practitioners in the treatment of TCM and Western medicine to play a greater role in Western medicine to effectively compensate for the surgery, radiotherapy and chemotherapy only attach importance to the treatment of the disease but have neglected the identified disease caused by the poor quality of survival time and survival of the obvious inadequate basis for identifying diseases in Western medicine, the scientific application of traditional Chinese medicine syndromes identified disease, so that Chinese and Western medicine treatment of combination therapy compared with Western medicine alone can significantly prolong the survival period of patients with colorectal cancer and improve quality of life.

Combined Chinese and Western medicine treatment of rectal cancer clinical significance. Methods: The forward-looking, controlled, randomized method to 57 cases of rectal cancer patients were divided into observation group and control group. The observation group 28 cases, the application surgery, adjuvant chemotherapy, and TCM drug treatment; control group, only 29 cases of surgery and adjuvant chemotherapy. Results: The observation group rate for a better quality of life score 75.00%, compared with the control group were significantly different (P <0.05); Observer Group of the chemotherapy toxicity of sub-degree lower than the Ⅰ degree 64.29%, compared with the control group were significantly different ; two groups a year, 2 years, 3-year survival rate was no significant difference. Conclusion: The combination of Chinese and Western medicine treatments in patients with rectal cancer to improve the quality of life and reduce the apparent toxicity of chemotherapy alone is superior to Western medicine treatment.
6.1 According to the principle of comprehensive treatment in patients with body mass, the tumor location, pathological type, depth of infiltration and metastasis of circumstances, a reasonable variety of integrated application of existing treatment, the complications of Western medical method of treatment using traditional Chinese medicine cross-checks with a view to the greatest limits increase the cancer cure rate and improve patient quality of life.

6.2 Selection of Early: line partial radical mastectomy. Traditional Chinese medicine treatment after consolidation. The medium-term: In the radical, based on the use of radiotherapy and traditional Chinese medicine to reduce local recurrence rate, narrowing the primary tumor, the tumor downstaging. Use of chemotherapy and traditional Chinese medicine (the right medicines and means) to reduce distant metastasis. TCM treatment of chemotherapy with radiation therapy to improve efficacy, reduce side effects, reduce peritoneal recurrence. The use of biological immune therapy to enhance the body immunity. Late: as much as possible removal of the primary foci of distant metastases can be operative as far as possible those operations, conditional voice of those who can use multiple warheads, radio-frequency therapy intervention therapy, in this based on the use of Chinese medicine, radiotherapy and chemotherapy. Of unresectable tumor, we should also take a positive attitude, in the bypass or ostomy and other symptomatic treatment, based on the external application of physical therapy and traditional Chinese medicine approach to localized lesions, and radiotherapy can be used to reduce blood in the stool, reduce pain, the appropriate Chinese medicine, systemic chemotherapy, intestinal thermo-chemotherapy, interventional treatment slowed tumor growth, improve symptoms, prolong survival and improve quality of life. With surgery as the center, can be used before surgery medicine, chemical, radiation or intra-arterial infusion chemotherapy in order to achieve "down period" the purpose of possible intraoperative radiation therapy, portal vein chemotherapy, intraperitoneal chemotherapy, regional infusion chemotherapy, postoperative according to tumor site, stage-line Chinese medicine, chemotherapy, thermotherapy, radiotherapy, biological methods such as comprehensive treatment of immune therapy. If found feasible, excision recurrence, tumor frequency or percutaneous ethanol injection therapy. The period can be used in patients with Chinese medicine treatment of cancer or reducing of, radiotherapy side effects.

In short, the comprehensive treatment of rectal cancer While there has been some progress, but how to organically combine a variety of treatments to improve the cure rate and reduce complications and side effects need to according to specific circumstances.