TY - JOUR
T1 - Preoperative endorectal brachytherapy in the treatment of locally advanced rectal cancer
T2 - Rethinking neoadjuvant treatment
AU - Biagioli, Matthew C.
AU - Herman, Joseph M.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/3
Y1 - 2014/3
N2 - Prior to the introduction of preoperative treatment and modern surgical technique, recurrence rates for locally advanced rectal cancer ranged from 30% to 50%. Since the widespread adoption of total mesorectal excision and preoperative chemoradiation therapy (CRT), local recurrence rates have reduced considerably to only 5-10%. However, preoperative treatment comes at a cost with significant acute and late toxicity. Additionally, 2 standards of care have emerged-1 week of radiation alone vs 5 weeks of concurrent chemoradiation. In this review, we evaluate toxicity associated with preoperative treatment as well as the key pathological factors that influence outcome in patients with locally advanced rectal cancer. Additionally, we discuss endorectal brachytherapy, an alternative preoperative treatment that may result in equivalent or improved response rates with less toxicity when compared to conventional CRT.
AB - Prior to the introduction of preoperative treatment and modern surgical technique, recurrence rates for locally advanced rectal cancer ranged from 30% to 50%. Since the widespread adoption of total mesorectal excision and preoperative chemoradiation therapy (CRT), local recurrence rates have reduced considerably to only 5-10%. However, preoperative treatment comes at a cost with significant acute and late toxicity. Additionally, 2 standards of care have emerged-1 week of radiation alone vs 5 weeks of concurrent chemoradiation. In this review, we evaluate toxicity associated with preoperative treatment as well as the key pathological factors that influence outcome in patients with locally advanced rectal cancer. Additionally, we discuss endorectal brachytherapy, an alternative preoperative treatment that may result in equivalent or improved response rates with less toxicity when compared to conventional CRT.
UR - http://www.scopus.com/inward/record.url?scp=84896712796&partnerID=8YFLogxK
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U2 - 10.1053/j.scrs.2013.09.003
DO - 10.1053/j.scrs.2013.09.003
M3 - Article
AN - SCOPUS:84896712796
VL - 25
SP - 26
EP - 32
JO - Seminars in Colon and Rectal Surgery
JF - Seminars in Colon and Rectal Surgery
SN - 1043-1489
IS - 1
ER -