Rectal cancer: the role of radiotherapy

Surgery is the definitive tool in the management of patients with rectal carcinoma. Early failure of treatment remains problematic and is manifest in local recurrence. Development of surgical techniques and inclusion of other treatment modalities aim to reduce the incidence of local recurrence and improve survival. This article examines the role of radiotherapy in the management of patients with rectal carcinoma and explores the controversies that exist in its application. The evidence for the use and benefits of radiotherapy in adjuvant and neoadjuvant settings is reviewed, and its application in association with total mesorectal excision considered.