Where should radiotherapy stand in the current era of rectal cancer management?

Abstract

Rectal cancer management can be defined as maximizing local tumor control and overall survival while preserving anal sphincter, bladder, and sexual functions or improving the quality of life with an overall reduction in morbidity. Appropriate preoperative or postoperative therapy is required to minimize the risks of both local and distant recurrence. Preoperative radiotherapy is the current standard for treating patients with high-risk rectal cancer owing to lower rates of local relapse and toxicity. Modern radiotherapy capabilities are well suited for any short- or long-course protocol with decreased toxicity in irradiated structures such as the small intestine, bladder, or femoral heads. As clinicians and researchers, we must aim to establish tailored treatments for these patients based on the most suitable evidence based ground in a multidisciplinary environment regarding the expectations of both our patients and team physicians. Herein, we present a review of ongoing clinical trials in order to shed light on the current debates of standard approaches for treating rectal cancer.