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Current Oncology Reports
Published in: Current Oncology Reports 3/2012

01-06-2012 | Gastrointestinal Cancers (L Saltz, Section Editor)

Toward the Non-surgical Management of Locally Advanced Rectal Cancer

Authors: Alice Dewdney, David Cunningham

Published in: Current Oncology Reports | Issue 3/2012

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Abstract

Neoadjuvant short-course radiotherapy and long-course chemoradiation (CRT) reduce local recurrence rates when compared to surgery alone and remain widely accepted as standard of care for patients with locally advanced rectal cancer. However, surgery is not without complications and a non-surgical approach in carefully selected patients warrants evaluation. A pathological complete response to CRT is associated with a significant improvement in survival and it has been suggested that a longer time interval between the completion of CRT and surgery increases tumor downstaging. Intensification of neoadjuvant treatment regimens to increase tumor downstaging has been evaluated in a number of clinical trials and more recently the introduction of neoadjuvant chemotherapy prior to CRT has demonstrated high rates of radiological tumor regression. Careful selection of patients using high-resolution MRI may allow a non-surgical approach in a subgroup of patients achieving a complete response to neoadjuvant therapies after an adequate time period. Clearly this needs prospective evaluation within a clinical trial setting, incorporating modern imaging techniques, and tissue biomarkers to allow accurate prediction and assessment of response.
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Metadata
Title
Toward the Non-surgical Management of Locally Advanced Rectal Cancer
Authors
Alice Dewdney
David Cunningham
Publication date
01-06-2012
Publisher
Current Science Inc.
Published in
Current Oncology Reports / Issue 3/2012
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-012-0234-z

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