title: Neoadjuvant chemotherapy alone for early-stage rectal cancer: an evolving paradigm?
abstract: Current management of early-stage rectal cancer comprises combinations of surgery, radiotherapy, and chemotherapy, with the presence or absence of several validated high-risk features determining which treatment modalities will be used and the order of administration. In high-risk individuals, most centers have adopted neoadjuvant combined chemotherapy and radiotherapy followed by surgery as the initial approach. However, long-term toxicity, limited survival gains, and high rates of distant failure have called this approach into question, with early data suggesting that neoadjuvant chemotherapy alone may be feasible in selected patient groups. This review discusses the current data and feasibility of managing early stage rectal cancer with neoadjuvant chemotherapy before surgical resection.
authors.affiliation: Royal Marsden Hospital, London & Surrey, United Kingdom.
authors.forename: Eliza A
authors.initials: EA
authors.lastname: Hawkes
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.forename: Diana
authors.initials: D
authors.lastname: Tait
authors.forename: Gina
authors.initials: G
authors.lastname: Brown
authors.forename: Ian
authors.initials: I
authors.lastname: Chau
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000592:standards*; D006801:Humans; D020360:Neoadjuvant Therapy / Q000592:standards*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018579:Patient Selection; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents