[Combined radiotherapy and surgery is best against rectal cancer]

The treatment of rectal cancer has changed dramatically during the past twenty years. Adjuvant radiotherapy has been shown to reduce the local recurrence rate by approximately 50 per cent, a reduction associated with a 10-20 per cent improvement in overall survival. Most trials designed to evaluate radiotherapy have not been optimised. Use of the modern mesorectal excision procedure in rectal cancer surgery has reduced the local recurrence rate and improved survival in cases treated with surgery alone. The article consists in a review of advances in our knowledge of radiotherapy and the value of improved surgery, and discussion of radiotherapy used in conjunction with optimised surgical treatment.