引用文本：李汝峰, 刘为民, 郭镔溢, 等. 《荷兰局部复发直肠癌国家指南》简介并部分解读[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(2):148-160.

作者：李汝峰¹，刘为民²，郭镔溢²，万和渊²，戴伟钢³

单位：1．中山大学附属第六医院粤西医院/信宜市人民医院 胃肠外科，广东 信宜 525300；2．纳雍县中医院 外科，贵州 毕节 553308；3．中山大学附属第一医院 胃肠外科中心，广东 广州 510080

Authors：Li Rufeng¹, Liu Weimin², Guo Binyi², Wan Heyuan², Dai Weigang³

Unit：1. Department of Gastrointestinal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Yuexi Hospital (Xinyi People's Hospital)，Xinyi 525300, Guangdong, China；2.  Department of Surgery, Nayong County Traditional Chinese Medicine Hospital, Bijie 553308, Guizhou, China；3. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-sen University，Guangzhou 510080, Guangdong, China

摘要：

全球范围内，结直肠癌发病率在所有恶性肿瘤中居第3位，死亡率居第2位。目前对于可切除的原发结直肠癌，手术仍然是主要治疗手段，但直肠癌根治性手术后仍有6%~12%发生局部复发。局部复发直肠癌的诊治目前颇具挑战性。由于复发直肠癌病例的治疗过程复杂，且目前多数研究为回顾性小样本研究，证据级别较低，缺乏足够的循证医学证据来指导治疗。2024年4月荷兰结直肠癌指南委员会在Cancer Treatment Reviews杂志上发布了第1版《荷兰局部复发直肠癌国家指南》。该指南系统回顾了近年来复发直肠癌的相关文献，从疾病诊断、影像学评估、放化疗、免疫治疗及手术治疗等多个方面详细阐述了关于局部复发直肠癌的诊断和治疗方案，为临床医生治疗决策提供了重要的参考依据。随着我国直肠癌发病率的逐年上升，直肠癌复发病例数也同步增长。因此，《荷兰局部复发直肠癌国家指南》对我国此类患者的诊治同样具有重要借鉴意义。本文对该指南进行全面系统的解读，旨在提高我国临床医生对局部复发直肠癌的诊疗水平，造福更多此类患者。

关键词：局部复发直肠癌；治疗；指南

Abstract：

The incidence rate of colorectal cancer ranks the third in the global incidence rate of malignant tumors, while the mortality ranks the second. At present, surgery remains the main treatment for resectable primary colorectal cancer. However, there were still 6%-12% local recurrences after radical surgery for rectal cancer. The diagnosis and treatment of locally recurrent rectal cancer is very challenging. The treatment process for patients with recurrent rectal cancer is complex, and most current studies are retrospective small sample studies with low levels of evidence. Therefore, there is a lack of sufficient evidence-based medicine to guide treatment. In April 2024, the Dutch Colorectal Cancer Guidelines Committee published the first edition of the Dutch national guidelines for locally recurrent rectal cancer in the journal Cancer Treatment Reviews. This guideline systematically reviewed the literatures related to recurrent rectal cancer in recent years, and elaborated on the diagnosis and treatment plans for locally recurrent rectal cancer from multiple aspects such as disease diagnosis, imaging evaluation, radiotherapy, chemotherapy, immunotherapy, and surgical treatment, providing important reference for clinical doctors' treatment decisions. With the incidence rate of rectal cancer rising year by year in China, the number of cases of recurrent rectal cancer is also growing. Therefore, the Dutch national guidelines for locally recurrent rectal cancer has important reference significance for guiding the diagnosis and treatment of such patients in China. This article provides a comprehensive and systematic interpretation of the Dutch guidelines, aiming to improve the diagnosis and treatment level of local recurrent rectal cancer among clinical doctors in China and benefit more such patients.

Key words：Locally recurrent rectal cancer; Treatment; Guideline

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