Neoadjuvant vs adjuvant pelvic radiotherapy for locally advanced rectal cancer: Which is superior?

Sarah Popek, Vassiliki Tsikitis

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The treatment of locally advanced rectal cancer including timing and dosage of radiotherapy, degree of sphincter preservation with neoadjuvant radiotherapy, and short and long term effects of radiotherapy are controversial topics. The MEDLINE, Cochrane Library databases, and meeting proceedings from the American Society of Clinical Oncology, were searched for reports of randomized controlled trials and meta-analyses comparing neoadjuvant and adjuvant radiotherapy with surgery to surgery alone for rectal cancer. Neoadjuvant radio therapy shows superior results in terms of local control compared to adjuvant radiotherapy. Neither adjuvant or neoadjuvant radiotherapy impacts overall survival. Short course versus long course neoadjuvant radio therapy remains controversial. There is insufficient datato conclude that neoadjuvant therapy improves rates of sphincter preserving surgery. Radiation significantly impacts anorectal and sexual function and includes both acute and long term toxicity. Data demonstrate that neoadjuvant radiation causes less toxicity compared to adjuvant radiotherapy, and specifically short courseneoadjuvant radiation results in less toxicity than long course neoadjuvant radiation. Neoadjuvant radio therapy is the preferred modality for administering radiation in locally advanced rectal cancer. There are significant side effects from radiation, including anorectal and sexual dysfunction, which may be less with short course neoadjuvantradiation.

Original languageEnglish (US)
Pages (from-to)848-854
Number of pages7
JournalWorld Journal of Gastroenterology
Volume17
Issue number7
DOIs
StatePublished - Feb 21 2011
Externally publishedYes

Fingerprint

Adjuvant Radiotherapy
Rectal Neoplasms
Neoadjuvant Therapy
Radiation
Radio
Radiotherapy
Radiotherapy Dosage
Radiation Effects
MEDLINE
Libraries
Meta-Analysis
Randomized Controlled Trials
Databases

Keywords

  • Adjuvant radiation
  • Chemoradiotherapy
  • Locally advanced rectal cancer
  • Neoadjuvant chemoradiotherapy
  • Neoadjuvantradiation
  • Rectal neoplasm

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Neoadjuvant vs adjuvant pelvic radiotherapy for locally advanced rectal cancer : Which is superior? / Popek, Sarah; Tsikitis, Vassiliki.

In: World Journal of Gastroenterology, Vol. 17, No. 7, 21.02.2011, p. 848-854.

Research output: Contribution to journalArticle

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