Abstract
Advances implemented in thecomplex treatment of distal rectal cancer led to a decrease in thenumber of loco-regional recurrences to 5-10%, but high rates of distant metastases remain at up to 30%. They lead to disappointing long-term oncological results, which requires thesearch for improvement of each of thestages of complex treatment. As a consequence of thequestionable effectiveness of adjuvant polychemotherapy for distal rectal cancer, thequestion of thepossibility of transferring drug treatment from an adjuvant to a neoadjuvant regimen is reasonably raised. Thepresented options for full neoadjuvant therapy have been developed and tested in leading oncology centers and are based on National Comprehensive Cancer Network Version 1.2022recommendations. It is premature to make categorical conclusions regarding therecommendation of one or another variant of their implementation. Our preliminary clinical results confirmed theneed for an additional stage of restaging in thesecond option, after 16weeks of polychemotherapy before chemoradiation, in order to exclude thegeneralization of thedisease. Therefore, there is a need for a prospective, controlled intercentre study to answer some unresolved questions.
Published Version
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