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New Neoadjuvant Treatment Strategies for Non-Metastatic Rectal Cancer (M0)

  • Adjuvant Therapy for Colon Cancers (AB Benson III and A de Gramont, Section Editors)
  • Published:
Current Colorectal Cancer Reports

Abstract

Rectal cancers stages II–III are presenting many various clinical situations. Neoadjuvant chemoradiotherapy is a standard of care in many cases, and in association with TME surgery, local relapses are becoming uncommon. None of these neoadjuvant treatments have so far improved survival, and quality of life remains non-optimal after abdomino-perineal resection and quite often after anterior resection. To increase survival through sterilization of subclinical distant metastases, new induction chemotherapy is tested. In T4 tumors, radiation dose escalation should be able to further improve local control, and in elderly patients, reduction of nCRT toxicity may provide better compliance to TME surgery. A promising approach is the use of optimal neoadjuvant treatment in early tumors in order to achieve a clinical complete response and propose an organ preservation either after local excision or using a meticulous and prolonged watch and wait strategy. Well-conducted randomized trials will be necessary to modify the present standard of care.

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Conflict of Interest

Jean-Pierre Gérard has received non-financial support from Ariane Medical Systems Ltd. (UK).

Jérôme Doyen declares that he has no conflict of interest.

Nicolas Barbet declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Pôle de radiothérapie Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189, Nice Cedex 2, France

    Jean-Pierre Gérard & Jérôme Doyen

  2. Centre de Radiothérapie, 44 rue Ambroise Paré, 71 000, Mâcon, France

    Nicolas Barbet

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  1. Jean-Pierre Gérard
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  2. Jérôme Doyen
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Correspondence to Jean-Pierre Gérard.

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This article is part of the Topical Collection on Adjuvant Therapy for Colon Cancers

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Gérard, JP., Doyen, J. & Barbet, N. New Neoadjuvant Treatment Strategies for Non-Metastatic Rectal Cancer (M0). Curr Colorectal Cancer Rep 11, 289–297 (2015). https://doi.org/10.1007/s11888-015-0287-0

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