The guidelines advocate for preoperative neoadjuvant radiotherapy and chemotherapy in cases of middle and low locally advanced rectal cancer. While some patients achieved pathological complete response (pCR), which is favorable and allows for potential organ preservation, treatment sensitivity varies and not all patients reach pCR. Identifying the factors influencing pCR is important for enhancing the effectiveness of neoadjuvant therapy and improving patient outcomes. Previous research has identified various factors associated with response to neoadjuvant therapy, which can serve as predictors of pCR. This study reviews recent literature on imaging, pathological, genetic, and molecular characteristics, laboratory indices, and therapeutic factors related to tumor response, both domestically and internationally. The aim is to summarize the latest advancements in understanding the factors associated with pCR in patients with locally advanced middle and low rectal cancer undergoing neoadjuvant therapy, thereby providing a theoretical foundation for standardized clinical treatment approaches.
指南推荐中低位局部进展期直肠癌行术前新辅助放化疗，部分患者治疗反应良好，表现为病理完全缓解（pCR），这为临床患者器官保留提供了可能。但是，由于治疗敏感性不同，仅部分局部进展期直肠癌患者在接受新辅助治疗后可以达到pCR。因此，明确影响pCR的因素，对于提高新辅助治疗效果、改善患者生存获益，具有重要意义。既往研究发现，多种因素与新辅助治疗反应相关，可以作为新辅助治疗后pCR的预测因素。本研究通过检索近年国内外文献，从肿瘤的影像学、病理学及基因和分子特征、实验室指标以及治疗因素等多个方面进行综述，明确局部进展期中低位直肠癌患者新辅助治疗后pCR相关因素的最新研究进展，以期为临床规范化治疗提供理论依据。.