title: An update on the multimodality of localized rectal cancer.
abstract: New strategies have reduced the local recurrence (LR) rate and extended the duration of overall survival (OS) in patients with localized rectal cancer (RC) in recent decades. The mainstay of curative treatment remains radical surgery; however, downsizing the tumor by neo-adjuvant chemo-radiotherapy and adjuvant cytotoxic therapy for systemic disease has shown significant additional benefit. The standardization of total mesorectal excision (TME), radiation treatment (RT) dose and fractionation, and optimal timing and sequencing of treatment modalities with the use of prolonged administration of fluoropyrimidine concurrent with RT have significantly decreased the rates of LR in locally advanced rectal cancer (LARC) patients. This review focuses on the optimization of multi-modality therapies in patients with localized RC.
authors.affiliation: Necmettin Erbakan University, Meram Medical Faculty, Department of Medical Oncology, Konya, Turkey. Electronic address: mehmetartac@yahoo.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Artac
authors.affiliation: Necmettin Erbakan University, Meram Medical Faculty, Department of Medical Oncology, Konya, Turkey. Electronic address: drlev2002@hotmail.com.
authors.forename: Levent
authors.initials: L
authors.lastname: Korkmaz
authors.affiliation: Winship Cancer Institute of Emory University, Department of Medical Oncology, Atlanta, United States. Electronic address: bassel.el-rayes@emoryhealthcare.org.
authors.forename: Bassel
authors.initials: B
authors.lastname: El-Rayes
authors.affiliation: Karmanos Cancer Center, Department of Gastrointestinal Oncology, Detroit, United States. Electronic address: philipp@karmanos.org.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Philip
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D006801:Humans; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Chemo-radiotherapy; Locally advanced; Neo-adjuvant; Rectal cancer; Surgery