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Should Biological Targeted Agents be Combined with Preoperative Chemoradiation in Rectal Cancer? An Update

  • Hélène Poels
  • Pieter-Jan Cuyle
  • Eric Van Cutsem
Chapter

Abstract

It has been shown that preoperative chemoradiation improves local control and sphincter preservation in the treatment of rectal cancer. It is associated with reduced toxicity but it does not improve survival when compared with postoperative therapy [1]. The advantages of preoperative chemoradiation in the treatment of locally advanced rectal cancer (LARC) have been clearly demonstrated. Neoadjuvant chemoradiotherapy (CRT) improves local control, as well as sphincter preservation rates [1]. Over the recent decades, neoadjuvant CRT with fluoropyrimidines followed by total mesorectal excision (TME) has become the standard therapy for locally advanced rectal cancer [1–3]. Although the local recurrence rate is generally low (<10%), systemic recurrence still remains a problem in about 25–30% of cases. In an attempt to improve disease-free survival (DFS) and overall survival (OS) rates, many studies have been conducted to investigate the role of the combination of radiotherapy with cytotoxic drugs and targeted agents and of radiosensitizing agents. This manuscript discusses the integration of epidermal growth factor receptor (EGFR) inhibitors and vascular endothelial growth factor (VEGF) inhibition in the neoadjuvant treatment for LARC.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  • Hélène Poels
    • 1
  • Pieter-Jan Cuyle
    • 1
  • Eric Van Cutsem
    • 1
  1. 1.Digestive OncologyUniversity Hospitals LeuvenLeuvenBelgium

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