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 whilepreserving anal sphincter, bladder, and sexual functions or improving the quality of life with an overallreduction in morbidity. Appropriate preoperative or postoperative therapy is required to minimize therisks of both local and distant recurrence. Preoperative radiotherapy is the current standard for treatingpatients 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 basedground in a multidisciplinary environment regarding the expectations of both our patients and teamphysicians. Herein, we present a review of ongoing clinical trials in order to shed light on the currentdebates of standard approaches for treating rectal cancer.