Current approaches in intensification of long-course chemoradiotherapy in locally advanced rectal cancer: a review
Open Access
- 25 June 2021
- journal article
- review article
- Published by Korean Society for Therapeutic Radiology and Oncology in Radiation Oncology Journal
- Vol. 39 (2), 83-90
- https://doi.org/10.3857/roj.2021.00108
Abstract
Rectal cancer is one of the most prevalent cancers in the world. In many countries, the current standard of care is long-course chemoradiation (CRT), followed by total mesorectal excision. Some efforts have been made by intensifying radiation or chemotherapy components of the neoadjuvant therapy to further decrease the local recurrence and augment surgery's feasibility and improve the oncological outcomes. This paper reviews recent intensified neoadjuvant interventions in locally advanced rectal cancer (LARC) in terms of efficacy and treatment-related toxicity. Many maneuvers have been made so far to improve the oncological outcomes of rectal cancer with intensified neoadjuvant longcourse CRT. Some of these approaches seem compelling and deserve further study, while some have just increased the treatment-related toxicities without evident benefits. Those endeavors with greater pathological complete response than the standard of care may make us await the long-term results on survival rates and chronic treatment-related toxicity. After introduction of neoadjuvant CRT for LARC there have been many efforts to improve its outcomes. Here, this study gathered most of these efforts that intensified the neoadjuvant therapy with some being promising and some being futile.Keywords
This publication has 37 references indexed in Scilit:
- Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trialAnnals of Oncology, 2015
- A randomized phase II study of capecitabine-based chemoradiation with or without bevacizumab in resectable locally advanced rectal cancer: clinical and biological featuresBMC Cancer, 2015
- Efficacy Endpoints of Radiation Therapy Group Protocol 0247: A Randomized, Phase 2 Study of Neoadjuvant Radiation Therapy Plus Concurrent Capecitabine and Irinotecan or Capecitabine and Oxaliplatin for Patients With Locally Advanced Rectal CancerInternational Journal of Radiation Oncology*Biology*Physics, 2014
- Neoadjuvant chemoradiation with concomitant boost radiotherapy associated to capecitabine in rectal cancer patientsInternational Journal of Colorectal Disease, 2014
- Complete pathological responses in locally advanced rectal cancer after preoperative IMRT and integrated-boost chemoradiationStrahlentherapie und Onkologie, 2014
- Comparison of two preoperative chemoradiotherapy regimens for locally advanced rectal cancer: capecitabine alone versus capecitabine plus irinotecanRadiation Oncology, 2013
- Clinical Outcome of the ACCORD 12/0405 PRODIGE 2 Randomized Trial in Rectal CancerJournal of Clinical Oncology, 2012
- Randomized Trial of Short-Course Radiotherapy Versus Long-Course Chemoradiation Comparing Rates of Local Recurrence in Patients With T3 Rectal Cancer: Trans-Tasman Radiation Oncology Group Trial 01.04Journal of Clinical Oncology, 2012
- Short-Course Radiation Versus Long-Course Chemoradiation for Rectal Cancer: Making ProgressJournal of Clinical Oncology, 2012
- Preoperative versus Postoperative Chemoradiotherapy for Rectal CancerThe New England Journal of Medicine, 2004