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The role of radiotherapy in the contemporary multimodality management of rectal cancer

E. Encheva, V. Ignatov, N. Kolev, K. Ivanov

Abstract

During the last 20 years the results of a significant number of trials concerning the multimodality management of rectal cancer have been published. This led to improvement of rectal cancer treatment. Radiotherapy (RT) is part of the standard multimodality treatment of rectal cancer and results in 50% local control improvement. The findings of the trials have answered some questions like the modalities sequencing, the combination of RT and chemotherapy, the RT fractionation regimens and the required total dose in addition to surgery either local or radical, the application of contact RT in early rectal cancer and intraoperative radiotherapy (IOR T) in locally advanced and recurrent rectal cancer. Neoadjuvant chemoradiation (CRT) followed by total mesorectal excision (TME) is the current standard treatment of patients with locally advanced rectal cancer with improved local control over postoperative CRT. In spite of the improved locoregional control, controversies exists and other opportunities for improvement are being investigated. In the present paper, the evidence behind the current standard of RT and the controversies in the treatment of patients with rectal cancer are reviewed.

Keywords

rectal cancer; multimodality management; radiotherapy; neoadjuvant chemoradiation; intraoperative radiotherapy; total mesorectal excision

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DOI: http://dx.doi.org/10.14748/ssm.v45i0.862

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About The Authors

E. Encheva
St. Marina University Hospital of Varna
Bulgaria

Department of Radiotherapy

V. Ignatov
St. Marina University Hospital of Varna
Bulgaria

Department of Radiotherapy

N. Kolev
St. Marina University Hospital of Varna
Brunei Darussalam

Department of Radiotherapy

K. Ivanov
St. Marina University Hospital of Varna
Bulgaria

Department of Radiotherapy

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