Counterpoint: long-course chemoradiation is preferable in the neoadjuvant treatment of rectal cancer |
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Authors: | Minsky Bruce D |
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Affiliation: | Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL 60637, USA. bruce.minsky@uchospitals.edu |
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Abstract: | There are 2 approaches to preoperative therapy. Short-course (25 Gy in 5 fractions) radiation and long-course (50.4 Gy in 28 fractions) radiation combined with chemotherapy (CMT). Although short-course radiation therapy is used in some European countries, it is not favored in all European countries or North America. Unlike long-course CMT, it cannot be safely combined with adequate doses of systemic concurrent chemotherapy, and, as currently designed, it does not increase sphincter preservation. Long-course CMT remains the preferred regimen for cT3 and/or node-positive disease. With parallel advances in staging, surgery, systemic therapy, and molecular markers, more selective approaches are being investigated. |
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