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Resectable Rectal Cancer: Preoperative Short-Course Radiation

  • Krzysztof Bujko
Part of the Methods of Cancer Diagnosis, Therapy, and Prognosis book series (HAYAT, volume 4)

Two randomized trials have demonstrated that preoperative radiotherapy is superior to postoperative radiotherapy in its ability to decrease local recurrence for rectal cancer (Frykholm et al., 1993; Sauer et al., 2004). In addition, the rates of early and late adverse effects have been lower with preoperative setting. The short-course radiation which consists of five fractions of 5 Gy delivered during 5 days with surgery carried out during the next week is the most extensively studied preoperative radiotherapy schedule in the frame of randomized studies. This schedule is commonly used as a routine treatment for resectable rectal cancer in Northern Europe. In contrast, in Southern Europe and in the U.S.A., conventionally fractionated radiotherapy (45–50 Gy, 1.8 or 2 Gy per fraction) given concurrently with chemotherapy and with surgery carried out 4–8 weeks later is preferred. The aim of this chapter is to provide theoretical rationale for the short-course radiation, to present its variants, long-term outcomes, early and late adverse effects and to evaluate the advantages and limitations of its use in relation to preoperative chemoradiation.

Keywords

Rectal Cancer Total Mesorectal Excision Preoperative Radiotherapy Biologically Effective Dose Locally Advanced Rectal Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science + Business Media B.V. 2009

Authors and Affiliations

  • Krzysztof Bujko
    • 1
  1. 1.Department of RadiotherapyMaria Sklodowska-Curie Memorial Cancer CentreWarsawPoland

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