Abstract
Colorectal cancer is one of the commonest cancers worldwide. Radiotherapy has been established as an indispensable component of treatment. Although conventional radiotherapy provides good local control, radiotherapy treatment side-effects, local recurrence and distant metastasis remain to be the concerns. With the recent technological advancements, various special radiotherapy treatment options have been offered. This review article discusses the recently-developed special radiotherapy treatment modalities for various conditions of colorectal cancer ranging from early stage, locally advanced stage, recurrent, and metastatic diseases. The discussion focuses on the areas of feasibility, local control, and survival benefits of the treatment modalities. This review also provides accounts of the future direction in radiotherapy of colorectal cancer with emphasis on the coming era of personalized radiotherapy.
Highlights
Colorectal cancer is one of the most common cancers worldwide
Intensity-modulated radiotherapy (IMRT), volumetric arc therapy (VMAT), helical tomotherapy and proton therapy for colorectal cancer are under development aiming for better conformality index and organs at risk (OARs) sparing than 3-dimension conformation radiotherapy (3DCRT) [3,4,5,6,7,8,9]
Most of the studies were small scale or dosimetric studies. Limitations of these techniques including organ motion, volume variability and dose inhomogeneity lead to the potential concern of underdosing due to rapid drop-off of dose beyond target volumes, more formal prospective trials are required to establish their clinical benefits over 3DCRT [3, 5, 10, 11]
Summary
Specialty section: This article was submitted to Radiation Oncology, a section of the journal. Colorectal cancer is one of the commonest cancers worldwide. Radiotherapy has been established as an indispensable component of treatment. Conventional radiotherapy provides good local control, radiotherapy treatment side-effects, local recurrence and distant metastasis remain to be the concerns. With the recent technological advancements, various special radiotherapy treatment options have been offered. This review article discusses the recently-developed special radiotherapy treatment modalities for various conditions of colorectal cancer ranging from early stage, locally advanced stage, recurrent, and metastatic diseases. The discussion focuses on the areas of feasibility, local control, and survival benefits of the treatment modalities. This review provides accounts of the future direction in radiotherapy of colorectal cancer with emphasis on the coming era of personalized radiotherapy
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