Chemoradiation therapy in the treatment of locally advanced rectal cancer

Abstract

Annotation. Total neoadjuvant therapy is a new approach to locally advanced rectal cancer that attempts to deliver both systemic chemotherapy and neoadjuvant chemoradiotherapy before surgery. However, its efficacy and safety remain controversial in randomized controlled trials. The purpose of this article is to analyze approaches to chemoradiation therapy in the complex treatment of locally advanced rectal cancer. A scientific search was carried out for the period from 2006 to 2022. according to the primary search strategy “chemoradiotherapy of rectal cancer”, “locally advanced rectal cancer”, and the AND/OR combination in the scientific databases MEDLINE (PubMed), Scopus, Web of Science. Although adjuvant chemotherapy after neoadjuvant chemoradiotherapy and surgery has not demonstrated significant benefit in randomized trials, immediate short-course induction chemotherapy may prevent or eradicate early (occult) micrometastatic disease and may be better tolerated than postoperative therapy expected greater ability to deliver full-dose chemotherapy preoperatively could theoretically improve local and systemic disease control, and thus increase cancer resectability.