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Radiotherapy in rectal cancer.
1Department of Oncology, Radiology and Clinical Immunology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
British Medical Bulletin
|November 8, 2002
Summary
Pre-operative radiotherapy significantly lowers local failure rates in rectal cancer patients, offering a slight survival benefit. Postoperative radiotherapy and radiochemotherapy also show benefits, with low morbidity when using appropriate techniques.
Area of Science:
- Oncology
- Radiation Oncology
Background:
- Radiotherapy is a cornerstone in rectal cancer management.
- Pre-operative radiotherapy is proven to reduce local recurrence.
- Total mesorectal excision complements radiotherapy in improving outcomes.
Purpose of the Study:
- To review the established role of radiotherapy in rectal cancer treatment.
- To evaluate the impact of radiotherapy on local failure and survival.
- To assess radiotherapy's role in non-resectable rectal cancer and sphincter preservation.
Main Methods:
- Analysis of randomized trials on pre-operative and post-operative radiotherapy.
- Review of data on radiotherapy morbidity.
- Evaluation of radiotherapy's effect on down-staging and surgical options.
Main Results:
- Pre-operative radiotherapy substantially reduces local failure in resectable rectal cancer.
- Postoperative radiotherapy and radiochemotherapy offer a slight survival improvement.
- Radiotherapy has low morbidity with appropriate techniques and can aid in non-resectable cases.
Conclusions:
- Pre-operative radiotherapy is highly effective in reducing local failure and improving survival in rectal cancer.
- Radiotherapy, with appropriate techniques, is a safe and effective treatment modality for rectal cancer.
- Further research is needed to define the role of pre-operative radio(chemo)therapy for sphincter preservation.