Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Dec;10(6):1238-1250.
doi: 10.21037/jgo.2018.12.04.

Radiation therapy for rectal cancer

Michelle Tseng  1 , Yu Yang Soon  1 , Balamurugan Vellayappan  1 , Francis Ho  1 , Jeremy Tey  1
Affiliations
Review

Radiation therapy for rectal cancer

Michelle Tseng et al. J Gastrointest Oncol. 2019 Dec.

Abstract

Radiotherapy (RT) has remained an important pillar in the multi-modality management of rectal cancer. Adjuvant RT with concurrent chemotherapy (chemo-RT) was once the standard of care for locally advanced rectal cancer, but with time, that has now changed and neoadjuvant chemo-RT followed by total mesorectal excision (TME) surgery is the new standard. Alternatively, neoadjuvant RT alone remains an option and clinicians are tasked to choose between the two. In an era of personalised oncological management, it is unsurprising that the treatment for rectal cancer is following suit and upcoming trials are studying ways to improve outcomes and minimise toxicity for patients while tailoring treatments specific to each patient's tumour. We review the evolution of the role of RT in rectal cancer and look forward to what the future holds.

Keywords: Radiotherapy (RT); rectal cancer; review.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Dose distribution for 3D conformal radiotherapy (left) and IMRT (right). Prescription dose 50.4 Gy. IMRT, intensity-modulated radiotherapy.
Figure 2
Figure 2
Dose distribution for rectal high dose rate brachytherapy. Prescription dose 8 Gy (100%), 12 Gy (150% of prescribed dose). Blue circle is the clinical target volume (CTV).
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. 10.3322/caac.21492 - DOI - PubMed
    1. Papillon J. Endocavity irradiation of early rectal cancers for cure: a series of 123 cases. Proc R Soc Med 1973;66:1179-81. 10.1177/003591577306601213 - DOI - PMC - PubMed
    1. Papillon J, Berard P. Endocavitary irradiation in the conservative treatment of adenocarcinoma of the low rectum. World J Surg 1992;16:451-7. 10.1007/BF02104446 - DOI - PubMed
    1. Myint AS. Novel radiation techniques for rectal cancer. J Gastrointest Oncol 2014;5:212-7. - PMC - PubMed
    1. Garcia-Aguilar J, Renfro LA, Chow OS, et al. Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial. Lancet Oncol 2015;16:1537-46. 10.1016/S1470-2045(15)00215-6 - DOI - PMC - PubMed