Onkológia 6/2009

Radiation therapy for rectal carcinoma

Radiation therapy plays a significant role in the complex management of all stages of rectal carcinoma. Combined with chemotherapy, radiotherapy is a standard adjuvant treatment modality the aim of which is prevention of the disease recurrence. Improved treatment results are seen with prolonged neodjuvant chemoradiotherapy followed by a total mesorectal surgical resection. However, the decrease in local recurrence is also observed after a short (1 week) course of radiation followed by tumor resection. Pathologic complete response is a significant predictor of survival; therefore all efforts focus on increasing the prevalance of pathologic complete response by combining different chemotherapeutic regimens with varied total doses, fractionation of radiation and target volumes. Undoubtedly, the best clinical results in the treatment of rectal cancer are achieved with mutlimodal therapy.

Keywords: rectal cancer, concurrent chemoradiation, preoperative treatment, adjuvant treatment, short-course radiotherapy, dowstaging