Optimal Neoadjuvant Therapy for Rectal Cancer: The Long and Short of It

摘要

There is significant debate regarding the optimal neoadjuvant regimen for patients with resectable rectal cancer. In many Northern European countries, the use of short-course preoperative radiotherapy (RT) alone (25 Gy in 5 fractions) followed by total mesorectal excision (TME) approximately 1 week later has become standard practice, supported by multiple randomized control trials comparing TME alone to preoperative short-course RT preceding surgery. In the United States and other parts of Europe, the use of long-course conventionally fractionated RT (50.4 Gy in 28 fractions) with concurrent administration of fluoropyrimidine-based chemotherapy is favored. At present, two published randomized control trials have compared outcomes of short-course RT to long-course chemoradiation (CRT).