Adjuvant and neoadjuvant chemoradiation or radiotherapy in rectal cancer--a review focusing on open questions.
BACKGROUND
The therapy of rectal cancer has been a matter of debate since decades, especially with regard to the benefits of neoadjuvant or adjuvant therapies. Principles of additional therapies have been established nearly two decades ago and are questioned nowadays on the basis of more recently modified operative techniques. Benefits and sequelae of therapies have to be balanced against each other, and it seems somewhat likely that a more differentiated strategy than simply stating that every patient with stage II and III rectal cancer needs chemoradiation or radiotherapy will, in long term, be recommended.


CONCLUSIONS
It should be kept in mind that results of centers of excellence and of phase-III studies with their positively selected patient populations are not representative for all the patients with rectal cancer and physicians treating them.
Klinik für Radioonkologie und Strahlentherapie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Lutz
L
Moser
Jörg-Peter
JP
Ritz
Wolfgang
W
Hinkelbein
Stefan
S
Höcht
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003657:Decision Making; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D015996:Survival Rate; D016896:Treatment Outcome
D000970:Antineoplastic Agents