[Radiotherapy in rectal carcinoma. Indications, side effects and after-care]

In patients at a high risk of developing a local recurrence or distant metastases, external beam radiotherapy used in combination with chemotherapy with 5-FU is indispensable. Adjuvant treatment is indicated for stage II and stage III rectal carcinoma, following tearing or cutting of the tumor, and/or following an R1 or R2 tumor resection. The neoadjuvant strategy comprises preoperative radiochemotherapy in the case of inoperable tumors or local recurrence, with the aim of enabling radical surgery. Radiation is applied to all sites likely to develop a recurrence. The fractionated radiation dose is 1.8-2 Gy/day, applied 5 times a week, for a total dose of 50 Gy at the dose reference point in the pelvis. Side effects include diarrhea, skin erosions and urological affections. Aftercare is provided on an interdisciplinary basis, initially at 6-week intervals, after 6 months at 3-month intervals, after one year every 6 months, and after 3 years once yearly.