Adjuvant Radiation Therapy for Colorectal Cancer
The use of adjuvant radiation therapy (XRT) after potentially curative surgery for colorectal cancer has decreased the incidence of local and regional failure more than in historical surgical controls. When radiation is most suitable for the patient with rectal cancer is unclear, since studies employing either pre- or postoperative XRT have demonstrated that both are beneficial. The patients with the highest risk of relapsing can be well defined by an assessment of the clinical description and the pathologic stage of the tumor. Compared with surgery alone, postoperative radiation treatment, with strict attention to treatment planning and localization to avoid excessive radiation doses in the small intestine, has been successful in reducing local recurrence to 10% or less without an increased complications rate. The continued use of adjuvant XRT (either pre- or postoperatively) in combination with systemic therapy is indicated if survival rates are to be improved.
KeywordsRectal Cancer Bowel Wall Local Failure Preoperative Irradiation Massachusetts General Hospital
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