Radiation therapy for advanced colorectal cancer

Locally advanced, inoperable, and recurrent colorectal cancer requires multitechnique therapy to achieve optimal control and palliation. The role of radiation therapy as an adjuvant in resectable rectal cancer has been studied extensively in clinical trials, but its role in more advanced disease has not been explored to the same extent. The use of radiation in colonic rather than rectal cancer is more problematic because of natural tissue tolerance constraints in the abdomen versus the pelvis. The current and past role of radiation in advanced colorectal cancer will be reviewed, and avenues of ongoing and future investigation will be outlined. The role of radiation for palliation also will be discussed.