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2007 (EN)
The role of radiotherapy in rectal cancer (EN)

N. Zamboglou2, H. Athanassiou, E. Fotopoulou,

SUMMARY Radiotherapy, and more recently radiochemotherapy, has been extensively used together with surgery in the management of rectal cancer. Pelvic radiotherapy can decrease local failure rates when it is used before or after surgery in resectable cancers, even when administered to patients who underwent total mesorectal excision (TME) surgery. Preoperative and postoperative adjuvant radiotherapy have both been proved effective but there is not yet a randomised trial proving the superiority of either of the two methods through direct comparison. Although the survival advantage of postoperative radiation therapy does not seem to be great, the data suggests that there may be a greater survival benefit with preoperative therapy. Preoperative radio(chemo)therapy has also been increasingly used in resectable low-lying tumours in order to facilitate a sphincter- preserving procedure by decreasing tumour size. The incidence of sphincter preservation varies between 23% and 70% and this conservative approach may be an alternative to abdominoperitoneal resection, with good functional outcome, in selected patients. In patients, with primarily unresectable cancer, preoperative radiotherapy is usually administered to cause tumour regression and allow radical surgery. Intraoperative radiation therapy (IORT) and the addition of systemic chemotherapy have been used in order to improve the results of preoperative radiotherapy. In patients with advanced unresectable rectal cancer, and also in elderly patients, pelvic radiotherapy can provide very effective palliation of the symptoms. (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 16, No 3 (2003) (EN)

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