期刊
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY
卷 3, 期 -, 页码 9-15出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ctro.2017.02.002
关键词
Rectal cancer; Wait and see; Organ preservation; Radiochemotherapy; Radiotherapy; Chemoradiotherapy
Neoadjuvant radiochemotherapy with subsequent total mesorectal excision is the standard of care for locally advanced rectal cancer. While this multimodal strategy has decreased local recurrences rates below 5%, long-term morbidities are considerable in terms of urinary, sexual or bowel functioning. At the same time approximately 10-20% of patients have no evidence of residual tumour in their surgical specimen. Pioneering studies from Brazil have suggested that surgery can safely be omitted in carefully selected patients with a clinical complete response after radiochemotherapy. Although confirmatory studies showed similar results, challenges in terms of optimizing radiochemotherapy for organ-preservation, appropriate selection of patients for non-operative management and the safety of this approach remain. The present review will summarize the current data on organ-preservation in rectal cancer and discuss the challenges that need to be addressed in future trials. (C) 2017 The Authors. Published by Elsevier Ireland Ltd on behalf of European Society for Radiotherapy and Oncology.
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