Review of Neoadjuvant Chemotherapy Alone in Locally Advanced Rectal Cancer

Abstract

This review demonstrates that neoadjuvant chemotherapy could be affectively administered in LARC and could provide a good alternative to chemoradiotherapy in moderate-risk rectal cancers without compromising short- and long-term outcomes.

Comparison of guidelines for the management of rectal cancer

“…Although results in terms of overall and disease‐free survival may be impressive, the therapeutic decision should be taken carefully by a multidisciplinary team, balancing possible benefits and drawbacks. Interestingly, neoadjuvant chemotherapy was not described by JSCCR guidelines, even though its positive outcomes have been widely demonstrated.…”

Recent advances in (chemo-)radiation therapy for rectal cancer: a comprehensive review

“…All of the mentioned strategies aimed at enhancing either the chemo- or the radiation part during concurrent chemoradiation and therefore allowed only moderate escalations due to concerns of toxicity. However, dose-intense combination chemotherapy regimens alone may result in considerable rates of downstaging and pCR rates as indicated by several studies [ 143 ]. Therefore, it seems reasonable to combine chemoradiation with sequential dose-intense combination chemotherapy in the neoadjuvant setting to improve pCR rates (known as TNT).…”

Clinical Guidelines for Diagnosis, Treatment and Monitoring Patients With Colorectal Cancer

“…28 Neoadjuvantno liječenje može započeti u obliku kemoterapije temeljene na oksaliplatini (FOLFOX, CAPEOX) ili kapecitabinu ili 5-FU/LV, praćeno prethodno opisanom kemoradioterapijom te zatim već opisanom kirurškom resekcijom. 29,30 Adjuvantna kemoradioterapija indicirana je bolesnicima s rakom rektuma T3-4, N1-2, a primjenjuje se na isti način kao i neoadjuvantna kemoradioterapija, nakon čega slijedi nastavak adjuvantne kemoterapije prema prije definiranim smjernicama adjuvantnog liječenja (IA). 28,[31][32][33][34] Perioperativno onkološko liječenje ne bi trebalo trajati više od 6 mjeseci.…”