[Adjuvant treatments in resectable cancer of the rectum: preoperative radiotherapy, postoperative radiation- and chemotherapy or nothing?].
In addition to curative surgical resection, which remains the treatment of choice in rectal cancer, are there any other effective adjuvant treatments capable of increasing the life expectancy of patients by decreasing the frequency of local recurrences and distant metastases? Analysis of the results and clinical arguments in favour of adjuvant treatments demonstrates the efficacy of preoperative radiotherapy which decreases the pelvic recurrence rate in patients with T2T3T4NxM0 tumours. Postoperative administration of a combination of radiotherapy and chemotherapy (5-FU, methyl CCNU) also improved the survival rate and disease-free interval in patients operated for rectal cancer. However, the adverse effects and toxicity of this adjuvant treatment limit its routine administration. Lastly, the efficacy of postoperative radiotherapy and postoperative chemotherapy, administered separately, has not been clearly demonstrated to date.
Gérard
A
A
Service de Chirurgie, Institut Jules Bordet, Centre des Tumeurs, Université Libre de Bruxelles, Belgique.
Pector
J C
JC
Van Houtte
P
P
Bleiberg
H
H
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D011182:Postoperative Care; D011300:Preoperative Care; D011829:Radiation Dosage; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery
Thérapeutiques adjuvantes du cancer du rectum résécable: radiothérapie pré-opératoire, radio-chimiothérapie post-opératoire ou rien?