The Evolving Role of Radiotherapy in Locally Advanced Rectal Cancer and the Potential for Nonoperative Management.
Rectal cancer
chemoradiation
chemotherapy
neoadjuvant therapy
nonoperative management
radiotherapy
watchful waiting
Journal
Oncology & hematology review
ISSN: 2052-3815
Titre abrégé: Oncol Hematol Rev
Pays: England
ID NLM: 101586931
Informations de publication
Date de publication:
2020
2020
Historique:
entrez:
25
8
2020
pubmed:
25
8
2020
medline:
25
8
2020
Statut:
ppublish
Résumé
Locally advanced rectal cancer has broadly been defined as T3, T4, or lymph node-positive disease. In the 1990s, adjuvant chemoradiation was considered the optimal management for locally advanced rectal cancer. However, the paradigm shifted when the German CAO/ARO/AIO-94 Rectal Cancer trial established neoadjuvant chemoradiation as the standard of care, based on reduced rates of toxicity and local recurrence, as well as higher rates of sphincter preservation compared with postoperative chemoradiation. Both short-course radiation and long-course chemoradiation are currently accepted methods for neoadjuvant treatment, with recent trials showing equivalence in outcomes. While surgery remains the cornerstone of treatment, there are data supporting the use of magnetic resonance imaging for risk stratification in rectal cancer and encouraging prospective data regarding nonoperative management. This review summarizes data on the evolution of treatment for locally advanced rectal cancer and discusses emerging evidence for nonoperative management.
Types de publication
Journal Article
Langues
eng
Pagination
43-51Subventions
Organisme : NCI NIH HHS
ID : R01 CA200800
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
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