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Treatment of locally advanced rectal cancer – is it time for a change?


Authors: R. Soumarová 1,2,3;  M. Škrovina 4
Authors‘ workplace: Oddělení radioterapie a onkologie, Komplexní onkologické centrum Nový Jičín, Nemocnice Nový Jičín, a. s. vedoucí centra: doc. MUDr. R. Soumarová, Ph. D., MBA 1;  Katedra interních oborů LF Ostravské univerzity vedoucí katedry: MUDr. I. Valkovský, Ph. D. 2;  Onkologické oddělení, Vzdělávací a výzkumný institut Agel, o. p. s. – pobočka Nový Jičín, Nemocnice Nový Jičín, a. s. primář: doc. MUDr. R. Soumarová, Ph. D., MBA 3;  Oddělení chirurgie, Komplexní onkologické centrum Nový Jičín, Nemocnice Nový Jičín, a. s. primář: MUDr. M. Škrovina, Ph. D. 4
Published in: Rozhl. Chir., 2017, roč. 96, č. 10, s. 415-420.
Category: Review

Overview

Treatment of locally advanced rectal cancer remains a very topical issue. The method of choice is surgery withpre- or postoperative chemoradiotherapy. Benefits of neoadjuvant chemoradiotherapy have been demonstrated in a number of randomized studies, including its advantages over postoperative treatment.Recently, however, there have been cases ofneoadjuvant chemoradiotherapy beingreplaced bychemotherapy alone. Although very controversial, another possible strategy for treating locally advanced rectal cancer is performing no operation in patients after neoadjuvant chemoradiotherapy who achieved complete remission. The necessity of using adjuvant chemotherapy after radical surgery and neoadjuvant chemoradiotherapy is also widely discussed. All these topicsareaddressed, albeit not exhaustively, in our paper. We are going to try to answer the question whether it is time for changes in the therapeutic strategy for advanced colorectal cancer.

Key words:
locally advanced rectal cancer − neoadjuvant chemoradiotherapy − induction chemotherapy


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