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Review paper
Published online: 2022-10-12
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Short-course radiotherapy as a part of total neoadjuvant therapy for locally advanced rectal cancer – a new standard?

Rafał Suwiński1, Marcin Zeman2, Iwona Dębosz-Suwińska3, Adam Idasiak1
DOI: 10.5603/NJO.a2022.0056
Affiliations
  1. IInd Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
  2. Department of Oncological and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
  3. Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland

open access

Ahead of print
Review article
Published online: 2022-10-12

Abstract

Selection of optimal perioperative treatment for rectal cancer remains a subject of controversies.  Recently established new rationales for 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 may be considered, at present, 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 controversies.  Recently established new rationales for 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 may be considered, at present, 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.

Get Citation

Keywords

rectal cancer; preoperative radiotherapy; total neoadjuvant treatment; chemotherapy; systemic treatment

About this article
Title

Short-course radiotherapy as a part of total neoadjuvant therapy for locally advanced rectal cancer – a new standard?

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Article type

Review paper

Published online

2022-10-12

Page views

41

Article views/downloads

45

DOI

10.5603/NJO.a2022.0056

Keywords

rectal cancer
preoperative radiotherapy
total neoadjuvant treatment
chemotherapy
systemic treatment

Authors

Rafał Suwiński
Marcin Zeman
Iwona Dębosz-Suwińska
Adam Idasiak

References (34)
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