Contact Radiation Therapy for Achieving Organ Preservation in Rectal Cancer After Standard Neoadjuvant Chemoradiation: Looking for a Place in the Sun

Abstract The role of radiation therapy in the treatment of (colo)-rectal cancer has changed dramatically over the past decades. Introduced with the aim of reducing the high rates of local recurrences after conventional surgery, major developments in imaging, surgical technique, systemic therapy and radiation delivery have now created a much more complex environment leading to a more personalized approach. Functional aspects including reduction of acute or late treatment-related side effects, sphincter or even organ-preservation and the unsolved problem of still high distant failure rates have become more important while local recurrence rates can be kept low in the vast majority of patients. This review summarizes the actual role of radiation therapy in different subgroups of patients with rectal cancer, including the current standard approach in different subgroups as well as recent developments focusing on neoadjuvant treatment intensification and/or non-operative treatment approaches aiming at organ-preservation.

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Comment on “Organ Preservation in cT2N0 Rectal Cancer After Neoadjuvant Chemoradiation Therapy”

Annals of Surgery ◽

10.1097/sla.0000000000003363 ◽

2019 ◽

Vol 270 (6) ◽

pp. e118-e119

Author(s):

Yoshiaki Kanemoto ◽

Tomohiro Kurokawa ◽

Tetsuya Tanimoto

Keyword(s):

Rectal Cancer ◽

Organ Preservation ◽

Neoadjuvant Chemoradiation ◽

Chemoradiation Therapy ◽

Neoadjuvant Chemoradiation Therapy

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Nonoperative Management for T2 Low Rectal Cancer: A Western Approach

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0040-1714241 ◽

2020 ◽

Vol 33 (06) ◽

pp. 366-371

Author(s):

Laura Melina Fernandez ◽

Guilherme Pagin São Julião ◽

Bruna Borba Vailati ◽

Angelita Habr-Gama ◽

Rodrigo Oliva Perez

Keyword(s):

Rectal Cancer ◽

Total Mesorectal Excision ◽

Organ Preservation ◽

Complete Response ◽

Tumor Stage ◽

Neoadjuvant Chemoradiation ◽

Major Surgery ◽

Early Rectal Cancer ◽

Mesorectal Excision ◽

Early Tumor

AbstractThe possibility of organ preservation in early rectal cancer has gained popularity during recent years. Patients with early tumor stage and low risk for local recurrence do not usually require neoadjuvant chemoradiation for oncological reasons. However, these patients may be considered for chemoradiation exclusively for the purpose of achieving a complete clinical response and avoid total mesorectal excision. In addition, cT2 tumors may be more likely to develop complete response to neoadjuvant therapy and may constitute ideal candidates for organ-preserving strategies. In the setting where the use of chemoradiation is exclusively used to avoid major surgery, one should consider maximizing tumor response. In this article, we will focus on the rationale, indications, and outcomes of patients with early rectal cancer being treated by neoadjuvant chemoradiation to achieve organ preservation by avoiding total mesorectal excision.

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Faculty Opinions recommendation of Non-operative management of rectal cancer after neoadjuvant chemoradiation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13323998.14688129 ◽

2011 ◽

Author(s):

Bruno Andreoni ◽

Gianmarco Contino

Keyword(s):

Rectal Cancer ◽

Operative Management ◽

Neoadjuvant Chemoradiation ◽

Non Operative Management

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