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How Long to Wait After Preoperative Radio(Chemo) Therapy to Perform Surgery?

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Multidisciplinary Management of Rectal Cancer

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Abstract

Preoperative radiotherapy or chemoradiotherapy (RT/CRT) is used in rectal cancer treatment to decrease the risk of a local recurrence in resectable tumours or to allow radical surgery in non-resectable tumours. In order not to increase the risk of complications after the surgery, surgery should be performed either before the acute radiation-induced toxicity has started, i.e. immediately after short-course RT (2–5 days), or after it has subsided 3–4 weeks after RT/CRT (i.e. 4–8 weeks after the last radiation fraction). Since regression of a rectal adenocarcinoma may take time and there presently is a wish to avoid (major) surgery in many patients, there is a growing interest in prolonging the interval from the RT/CRT to surgery to achieve maximal tumour regression. The pros and cons of delaying surgery are dependent upon the aim of the preoperative RT/CRT.

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Authors and Affiliations

  1. Department of Surgical Science, Uppsala University, Uppsala, Sweden

    Lars Påhlman

  2. Department of Immunology, Genetics and Pathology, Section of Experimental and Clinical Oncology, Uppsala University, SE-751 85, Uppsala, Sweden

    Bengt Glimelius

Authors
  1. Lars Påhlman
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  2. Bengt Glimelius
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Correspondence to Bengt Glimelius .

Editor information

Editors and Affiliations

  1. Dept. of Radiation Oncology, Università Cattolica S Cuore, Rome, Italy

    Vincenzo Valentini

  2. Head, Div. Clinical Oncology Research, University Clinic Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Sachsen-Anhalt, Germany

    Hans-Joachim Schmoll

  3. Department of Surgery, Leiden Univ Med Ctr, Leiden, The Netherlands

    Cornelis J. H. van de Velde

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Påhlman, L., Glimelius, B. (2018). How Long to Wait After Preoperative Radio(Chemo) Therapy to Perform Surgery?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43217-5_55

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  • DOI: https://doi.org/10.1007/978-3-319-43217-5_55

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