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Neoadjuvant Short-Course Radiation Therapy for Rectal Cancer: Trends and Controversies

  • Gastrointestinal Cancers (J Meyer, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

For patients with locally advanced rectal cancer, neoadjuvant hypofractionated short-course radiation remains an underutilized regimen in the USA. We review the current clinical literature highlighting the relative merits of short-course radiation, along with modern neoadjuvant strategies that incorporate its use.

Recent Findings

As compared to long-course chemoradiation with delayed surgery, short-course radiation with early surgery offers similar oncologic efficacy for locally advanced rectal cancer patients. Delaying surgery after short-course radiation decreases post-operative complications as compared to early surgery and improves tumor downstaging. Delaying surgery also offers the opportunity to administer neoadjuvant systemic therapy, which may help increase local-regional tumor response and potentially decrease distant relapse rates, the latter a persisting problem in rectal cancer treatment.

Summary

Short-course radiation, either with immediate or with delayed surgery, represents an appealing treatment alternative to long-course chemoradiation for patients with locally advanced rectal cancer.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Department of Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21287, USA

    Amol K. Narang & Jeffrey Meyer

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  1. Amol K. Narang
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Correspondence to Amol K. Narang.

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Conflict of Interest

Amol K. Narang declares that he has no conflict of interest.

Jeffrey Meyer has received clinical trial support from Peregrine Pharmaceuticals and DFINE, Inc., and has received royalties from UpToDate.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Gastrointestinal Cancers

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Narang, A.K., Meyer, J. Neoadjuvant Short-Course Radiation Therapy for Rectal Cancer: Trends and Controversies. Curr Oncol Rep 20, 68 (2018). https://doi.org/10.1007/s11912-018-0714-x

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