Recent advances of neoadjuvant chemoradiotherapy in rectal cancer: Future treatment perspectives. Issue 1 (24th October 2018)

• Record Type: Journal Article
• Authors: Yamashita, Kimihiro; Matsuda, Takeru; Hasegawa, Hiroshi; Mukohyama, Junko; Arimoto, Akira; Tanaka, Tomoko; Yamamoto, Masashi; Matsuda, Yoshiko; Kanaji, Shingo; Nakamura, Tetsu; Sumi, Yasuo; Suzuki, Satoshi; Kakeji, Yoshihiro
• Is Part Of: Annals of gastroenterological surgery. Volume 3:Issue 1(2019)
• Page Start: 24
• Page End: 33
• Publication Date: 2018-10-24
• Subjects: adjuvant chemotherapy -- chemoradiotherapy -- lateral lymph node dissection -- oxaliplatin -- rectal cancer; Digestive organs -- Surgery -- Periodicals; 617.43
• DOI: 10.1002/ags3.12213
• Languages: English
• ISSNs: 2475-0328

Abstract

Abstract: Neoadjuvant chemoradiotherapy (nCRT) has been widely used as a multidisciplinary approach for stage II/III rectal cancer. However, its safety and efficacy are controversial because previous studies have shown conflicting outcomes. The present review aimed to elucidate the benefits and limitations of nCRT for patients with rectal cancer. Future perspectives of nCRT are also described. No recent randomized trials have been able to show a survival benefit, although many studies have demonstrated good local control with the use of fluoropyrimidine (e.g. 5‐fluorouracil [FU] or capecitabine)‐based nCRT. Addition of oxaliplatin (OX) to FU‐based nCRT might improve overall survival by preventing distant metastasis, as shown in recent meta‐analyses. However, control of adverse effects is an important concern with this treatment. New treatment strategies such as nonoperative management (watch and wait policy) and total neoadjuvant therapy (TNT) are promising, but the establishment of reliable diagnostic methods of metastasis is essential. Development of new biomarkers is also necessary to select patients who are more likely to benefit from nCRT. Abstract : This review addresses the role of nCRT in a multidisciplinary approach for rectal cancer from the literature and introduces some new treatment procedures based on nCRT.