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Clin Colon Rectal Surg 2007; 20(3): 167-181
DOI: 10.1055/s-2007-984861
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Adjuvant Therapy for Rectal Cancer

Smitha S. Krishnamurthi1 , 2 , Yuji Seo3 , Timothy J. Kinsella2 , 3
  • 1Department of Medicine, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio
  • 2Case Comprehensive Cancer Center, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio
  • 3Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio
Further Information

Publication History

Publication Date:
31 July 2007 (online)

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ABSTRACT

Patients with stage II and III rectal cancer benefit from a multidisciplinary approach to treatment. Studies of postoperative adjuvant therapy consistently demonstrate decreases in locoregional recurrence with the use of radiation therapy. The use of postoperative chemotherapy results in improved disease-free survival and overall survival in certain studies. Preoperative radiation therapy decreases locoregional recurrence and in one study demonstrated an improvement in survival. The addition of chemotherapy to preoperative radiation results in improved locoregional control, but not survival. Preoperative chemoradiation is the standard of care for patients with clinical stage II and III rectal cancer in the United States due to improved local recurrence, acute and late toxicity, and sphincter preservation compared with postoperative chemoradiation. Promising approaches include the incorporation of new chemotherapeutic and biologic agents into chemoradiation and adjuvant chemotherapy regimens; new radiation techniques, such as the use of intraoperative radiation therapy and an accelerated concomitant radiation boost; and gene and protein expression profiling, to better predict response to treatment and prognosis.

KEYWORDS

Rectal cancer - radiation - chemotherapy - adjuvant - review

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Timothy J KinsellaM.D. 

Department of Radiation Oncology, University Hospitals Case Medical Center

11100 Euclid Ave. LTR 6068, Cleveland, OH 44106

Email: timothy.kinsella@UHhospitals.org

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