Preoperative Treatment of Locally Advanced Rectal Cancer: Assets and Drawbacks of Short Course and Long Course in Clinical Practice

• Published in: Seminars in radiation oncology Vol. 26; no. 3; pp. 186 - 192
• Main Author: Ngan, Samuel Y.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2016
• Subjects: Chemoradiotherapy; Combined Modality Therapy; Hematology, Oncology and Palliative Medicine; Humans; Neoadjuvant Therapy; Preoperative Care - methods; Radiology; Radiotherapy, Adjuvant; Randomized Controlled Trials as Topic; Rectal Neoplasms - pathology; Rectal Neoplasms - radiotherapy; Rectal Neoplasms - therapy
• ISSN: 1053-4296; 1532-9461
• DOI: 10.1016/j.semradonc.2016.02.007

Preoperative short-course radiotherapy and preoperative long-course chemoradiotherapy are the standards of care for high-risk rectal cancer in different parts of the world. Both treatments are effective in local control and carry a low morbidity. The advantage of short course is its simplicity, whereas long course has the advantage of downsizing tumors thus increasing the chance of sphincter preservation. Although 2 randomized trials comparing short course and long course have been performed, the better form of preoperative treatment remains a subject of discussion. This article reviews the evidence supporting each approach, and it discusses their relative merits and future directions.