CAJ | 학술논문

直肠癌新辅助放疗后的外科治疗策略选择非常复杂,需慎重权衡并发症发生率、肛门功能、局部复发率和长期生存率之间的关系,选择是密切观察、行局部切除术,还是行根治性手术.原发肿瘤的放疗敏感性与肠系膜淋巴结的放疗敏感性之间存在着高度的一致性,可用于指导治疗决策.放疗疗效显著者建议先行局部切除术,然后根据病理结果决定后续治疗方案；疗效不佳者建议直接手术.根治性手术的远切缘距离应大于1 cm;并建议在放疗前对肿瘤的边缘进行标记.
직장암신보조방료후적외과치료책략선택비상복잡,수신중권형병발증발생솔、항문공능、국부복발솔화장기생존솔지간적관계,선택시밀절관찰、행국부절제술,환시행근치성수술.원발종류적방료민감성여장계막림파결적방료민감성지간존재착고도적일치성,가용우지도치료결책.방료료효현저자건의선행국부절제술,연후근거병리결과결정후속치료방안；료효불가자건의직접수술.근치성수술적원절연거리응대우1 cm;병건의재방료전대종류적변연진행표기.
For locally advanced rectal cancer after neoadjuvant radiation,it is difficult to make a choice between close observation,local resection,and radical resection.The decision should be made after carefully weighing postoperative complications,anal function,local recurrence and long-term survival.There is a high consistency of the radiosensitivity between primary tumor and mesenteric lymph node,which may be used to guide the treatment decisions.If the primary tumor shrinks significantly after neoadjuvant radiation,local resection is recommended,and the next treatment plan should be made based on the pathological examination of resected specimen.Transabdominal radical resection is recommended for unfavorable tumors.Distal resection margin should be at least 1 cm,and marking the inferior margin of tumor is also recommended before neoadjuvant radiation since it would shrink significantly after radiation.