Radiotherapy and Chemoradiation for Rectal Cancer: State of the Art in Europe, the USA and Asia

Abstract

In rectal cancer treatment, not only the local primary but also regional and systemic tumour deposits must be taken care of. The three major treatments, surgery, radiotherapy and drugs, each with their own advantages and limitations, must be combined to result in improved outcomes. Several large randomised trials, reviewed here, have proven that combinations of the three modalities have markedly improved the locoregional problem, but not yet had any major infl uence on the systemic problem, and thus overall survival. The best integration of the so far weakest modality, the drugs, is not known. The results of the trials are interpreted differently in the world. A new generation of trials exploring the best sequence of treatments, together with integration of the novel drugs, is required.