Have the changes in treatment of rectal cancer made a significant difference to our patients? Journal Article


Authors: Benson, A. B. 3rd; Guillem, J. G.; Minsky, B. D.
Article Title: Have the changes in treatment of rectal cancer made a significant difference to our patients?
Abstract: The treatment for patients with locally advanced, resectable rectal cancer has evolved over the years. Various combinations and sequences of chemotherapy, radiation therapy, and total mesorectal excision (TME)-based surgery are the mainstay of current therapy. Preoperative combined chemoradiation, followed by surgery, is now the preferred treatment strategy, with the majority of patients receiving either infusion fluorouracil (5-FU) or capecitabine (Xeloda) with radiation. Clinical trials with oxaliplatin (Eloxatin)-based neoadjuvant chemoradiation have not shown improvement in the pathologic complete response rate (pCR) compared with 5-FU; however, final data addressing local recurrence rates and disease-free survival are pending.The use of adjuvant chemotherapy following preoperative chemoradiation and surgery has not been optimally defined. Some studies have shown that patients who obtained significant pathologic downstaging after chemoradiation and surgery have improved survival with the use of adjuvant chemotherapy. Since FOLFOX (folinic acid, 5-FU, and oxaliplatin) is the preferred adjuvant chemotherapy regimen for stage III colon cancer based on randomized clinical trial results, FOLFOX is also recommended for rectal cancer patients as an adjuvant therapy approach.
Keywords: treatment outcome; review; adjuvant therapy; chemotherapy, adjuvant; neoadjuvant therapy; radiotherapy, adjuvant; pathology; adjuvant chemotherapy; rectal neoplasms; rectum tumor; adjuvant chemoradiotherapy; chemoradiotherapy, adjuvant
Journal Title: Oncology (Norwalk)
Volume: 25
Issue: 14
ISSN: 0890-9091
Publisher: C M P Medica LLC * The Oncology Group  
Date Published: 2011-12-01
Start Page: 1323
End Page: 1329
Language: English
PUBMED: 22329182
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 7 May 2013" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Jose Guillem
    414 Guillem