Radiation therapy in colorectal carcinoma

In spite of advances in surgical technique and patient management, there continues to be a high rate of local recurrence for the advanced stages of rectal and colon carcinomas. The addition of radiotherapy to the treatment of colorectal carcinoma, however, has diminished the local recurrence rate; the acute and chronic toxicity is tolerable, and the patients with higher stages benefit from the combined modality. It is recommended that modified Astler-Coller stages B2 or greater receive some form of adjuvant radiotherapy. The ideal sequencing and the benefit of combining radiation with chemotherapy has not yet been determined. The use of intraoperative radiotherapy is very promising and continues to be investigated for initially unresectable lesions and recurrent lesions.