Abstract
Preoperative radiotherapy and chemoradiation are considered standards of care for stage II and III rectal cancer patients. Pelvic radiotherapy for rectal cancer can lead to significant acute and late toxicity. Studies have shown that the risk of gastrointestinal toxicity is associated with the volume of small bowel exposed to radiation therapy, especially at doses around 15 Gy. Intensity-modulated radiation therapy (IMRT) could potentially reduce dose to small bowel and other normal structures, thereby reducing gastrointestinal and other side effects from radiotherapy. Dosimetric studies have demonstrated that IMRT could improve sparing of small bowel from radiation. However, only a limited number of clinical studies have evaluated the role of IMRT for preoperative treatment of rectal cancer.
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