[Adjuvant radiotherapy of rectal cancer]

During the past decades the effect radiotherapy as adjuvant treatment of rectal cancer has been investigated in several prospective randomized trials. Only a marginal effect has been demonstrated on overall survival rate (3-4%) whereas the local recurrence rate can be significantly reduced by 33-50%. Using modern techniques the side-effects can be reduced to an insignificant level. Patients with rectal cancer who are not entering randomized prospective trials should be considered for pre-operative radiotherapy. Patients should be staged by preoperative CT-scanning and endoluminal ultrasound. Additionally, a down-staging effect and a reduction in tumor-size can be expected and accordingly an increase in resectability rate and a higher rate of sphincter-saving operations for large of fixed tumors is likely to be obtained.