Preoperative combined modality treatment for rectal cancer

The encouraging results achieved with adjuvant postoperative combined modality therapy in patients with resectable rectal cancer has prompted an increased interest in preoperative combined modality therapy. Based on the potential of such regimens to deliver higher chemotherapy doses, enhance downstaging, and decrease acute toxicity in patients with unresectable disease, this approach is attractive in patients with resectable rectal cancer. Randomized trials of preoperative vs postoperative combined modality therapy using combinations of bolus fluorouracil and leucovorin are in progress.