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Short-course radiotherapy as part of total neoadjuvant therapy for locally advanced rectal cancer – a new standard?
, 2, 3, 1
Affiliations- II Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
- Department of Oncological and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
- Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
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Abstract
Selection of optimal perioperative treatment for rectal cancer remains a subject of controversy. Recently established new rationales for the use of short-course preoperative radiotherapy (SCRT – 25 Gy in 5 fractions), instead of standard long-course preoperative radio-chemotherapy (LCRT-CT), are presented and discussed in the present review. New data suggest that short-course radiotherapy combined with 6 cycles of CAPOX, or 9 of FOLFOX4, at present may be considered the best option for perioperative treatment of high-risk rectal cancer. However, there is a clear need to further optimize preoperative treatment using rapidly evolving markers of treatment response, including microsatellite instability and targetable or predictive tumour mutations.
Abstract
Selection of optimal perioperative treatment for rectal cancer remains a subject of controversy. Recently established new rationales for the use of short-course preoperative radiotherapy (SCRT – 25 Gy in 5 fractions), instead of standard long-course preoperative radio-chemotherapy (LCRT-CT), are presented and discussed in the present review. New data suggest that short-course radiotherapy combined with 6 cycles of CAPOX, or 9 of FOLFOX4, at present may be considered the best option for perioperative treatment of high-risk rectal cancer. However, there is a clear need to further optimize preoperative treatment using rapidly evolving markers of treatment response, including microsatellite instability and targetable or predictive tumour mutations.
Keywords
rectal cancer; preoperative radiotherapy; total neoadjuvant treatment; chemotherapy; systemic treatment
About this articleTitle
Short-course radiotherapy as part of total neoadjuvant therapy for locally advanced rectal cancer – a new standard?
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
372-377
Published online
2022-10-12
Page views
3431
Article views/downloads
379
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2022;72(6):372-377.
Keywords
rectal cancer
preoperative radiotherapy
total neoadjuvant treatment
chemotherapy
systemic treatment
Authors
Rafał Suwiński
Marcin Zeman
Iwona Dębosz-Suwińska
Adam Idasiak
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