title: Neoadjuvant chemotherapy without radiotherapy for locally advanced rectal cancer.
abstract: Chemoradiotherapy or short-course radiotherapy followed by surgery is a standard treatment for locally advanced rectal cancer. This multimodality strategy has reduced the risk of local recurrence but failed to improve survival. Moreover, mid- and long-term side effects of radiotherapy have been reported. Alternative strategies have been investigated in an attempt to minimize treatment-related toxicities and improve outcome. Neoadjuvant chemotherapy without radiotherapy is an attractive therapeutic option that yields theoretical advantages. Moreover, if carefully selected, patients may be spared the effects of radiotherapy without compromising the oncology outcome. The authors review the available evidence on neoadjuvant chemotherapy without radiotherapy in locally advanced rectal cancer and try to anticipate potential algorithms of treatment selection to implement in clinical practice in the future.
authors.affiliation: Department of Medicine, The Royal Marsden NHS Foundation Trust, London & Surrey, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sclafani
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000532:radiotherapy; D016896:Treatment Outcome
keywords: MRI; chemoradiotherapy; neoadjuvant chemotherapy; radiotherapy; rectal cancer; total mesorectal excision