中国直肠癌放射治疗指南(2020年版)

摘要/Abstract

中国医师协会放射肿瘤治疗医师分会, 中华医学会放射肿瘤治疗学分会, 中国抗癌协会肿瘤放射治疗专业委员会. 中国直肠癌放射治疗指南(2020年版)[J]. 国际肿瘤学杂志, 2021, 48(7): 389-401.

图/表5

表1

根据T/N分期和位置的直肠癌术前放疗CTV勾画"

项目	盆腔骶前区	直肠系膜区	髂内淋巴引流区	闭孔淋巴引流区	髂外淋巴引流区	肛门括约肌复合体	坐骨直肠窝	腹股沟淋巴引流区
cT₃N₀,高位	+	+	+
cT₃N₀,中低位^a	+	+	+			+(肛管受侵)	^c	^d
任何T,直肠系膜/骶前淋巴结转移	+	+	+	+		+(肛管受侵)	^c	^d
任何T,髂内淋巴结转移	+	+	+	+		+(肛管受侵)	^c	^d
任何T,闭孔淋巴结转移	+	+	+	+	+	+(肛管受侵)	^c	^d
cT₄,前盆腔器官受侵^b	+	+	+	+	+	+(肛管受侵)	^c	^d

表1

项目	Dixon术后	Miles术后
吻合口/会阴瘢痕	+(吻合口)	+(会阴瘢痕)
瘤床	+	+
骶前区+直肠系膜区+ 髂内淋巴引流区^a	+	+
闭孔淋巴引流区	+	+
髂外淋巴引流区	-	-
腹股沟淋巴引流区	-	-
坐骨直肠窝	+(肿瘤中心距肛门缘6 cm以内)	+
肛门括约肌复合体		已切除

表2

图1

图2

图3

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中国直肠癌放射治疗指南(2020年版)

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[3]	王俊毅, 洪楷彬, 纪荣佳, 陈大朝.癌结节对结直肠癌根治性切除术后肝转移的影响[J]. 国际肿瘤学杂志, 2024, 51(5): 280-285.
[4]	李书月, 马辰莺, 周菊英, 徐晓婷, 秦颂兵.寡转移非小细胞肺癌的放疗进展[J]. 国际肿瘤学杂志, 2024, 51(3): 170-174.
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[8]	高新雨, 李振江, 孙洪福, 韩丹, 赵倩, 刘成新, 黄伟.基于MR加速器的MR引导放疗在食管癌患者中的临床应用[J]. 国际肿瘤学杂志, 2024, 51(1): 37-42.
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[10]	刘德宝, 孙子雯, 鲁守堂, 徐海东.ASB6在结直肠癌组织中的表达及临床意义[J]. 国际肿瘤学杂志, 2023, 50(8): 470-474.
[11]	李青珊, 谢鑫, 张楠, 刘帅.放疗联合系统治疗在乳腺癌中的应用进展[J]. 国际肿瘤学杂志, 2023, 50(6): 362-367.
[12]	陈卓, 陶俊, 陈琳, 柯晶.外周血miR-194联合粪便miR-143检测对结直肠癌临床筛查的价值[J]. 国际肿瘤学杂志, 2023, 50(5): 268-273.
[13]	许萌, 姜伟, 朱海涛, 曹雄锋.癌相关成纤维细胞在肿瘤放疗抵抗中的研究进展[J]. 国际肿瘤学杂志, 2023, 50(4): 227-230.
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