[Preoperative chemotherapy in locally advanced rectal cancer: systematic review of literature].
Nowadays, neoadjuvant radiotherapy represents the gold standard in the treatment of locally-advanced rectal cancer. Likewise, a lot of evidences seems to suggest that preoperative chemotherapy could improve the local control of the disease, favour the downstaging of the tumor, and make possible an higher number of conservative, sphincter-sparing surgical approaches. In our paper we systematically reviewed the evidences of literature to detect both the main benefits and the limits of pre-operative chemotherapy in the treatment of locally advanced rectal cancer. Moreover, we critically reviewed both the main outcomes of preoperative chemotherapy (overall survival, disease-free interval, number of conservative, sphincter-sparing surgical approaches) and its safety (acute and chronic safety), to give clinicians an evidence-based support for their clinical practice.
Tamburini
Emiliano
E
Divisione di Oncologia, Ospedale Infermi, IRST, Istituto Scientifico dei Tumori della Romagna, Rimini. bagabrk@libero.it
Tassinari
Davide
D
Papi
Maximilian
M
Nicoletti
Stefania
S
Fantini
Manuela
M
Ravaioli
Alberto
A
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D018849:Controlled Clinical Trials as Topic; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D015201:Meta-Analysis as Topic; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011300:Preoperative Care; D011878:Radiotherapy / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome