Preoperative radiotherapy for adenocarcinoma of the rectum

Curative surgery remains the principal treatment for rectal carcinoma. Unfortunately failure following surgery, particularly through local recurrence, is an all too common event. Among the potential adjuvant therapies, preoperative radiotherapy holds clear promise. A review of the clinical trials evaluating this treatment modality shows that it can decrease the rate of local recurrence and may even improve the overall 5-year survival. Preoperative radiotherapy is consistently well tolerated up to doses as high as 60 Gy; it does not complicate the surgical resection or increase the perioperative morbidity and mortality. Preoperative radiotherapy warrants further investigation to select those patients who are most likely to benefit from it.