Open AccessRecent advances of neoadjuvant chemoradiotherapy in rectal cancer: Future treatment perspectives
Author(s) -
Yamashita Kimihiro,
Matsuda Takeru,
Hasegawa Hiroshi,
Mukohyama Junko,
Arimoto Akira,
Tanaka Tomoko,
Yamamoto Masashi,
Matsuda Yoshiko,
Kanaji Shingo,
Nakamura Tetsu,
Sumi Yasuo,
Suzuki Satoshi,
Kakeji Yoshihiro
Publication year - 2019
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12213
Subject(s) - chemoradiotherapy , colorectal cancer , medicine , neoadjuvant therapy , oncology , cancer , breast cancer
Neoadjuvant chemoradiotherapy ( nCRT ) has been widely used as a multidisciplinary approach for stage II / III rectal cancer. However, its safety and efficacy are controversial because previous studies have shown conflicting outcomes. The present review aimed to elucidate the benefits and limitations of nCRT for patients with rectal cancer. Future perspectives of nCRT are also described. No recent randomized trials have been able to show a survival benefit, although many studies have demonstrated good local control with the use of fluoropyrimidine (e.g. 5‐fluorouracil [ FU ] or capecitabine)‐based nCRT . Addition of oxaliplatin ( OX ) to FU ‐based nCRT might improve overall survival by preventing distant metastasis, as shown in recent meta‐analyses. However, control of adverse effects is an important concern with this treatment. New treatment strategies such as nonoperative management (watch and wait policy) and total neoadjuvant therapy ( TNT ) are promising, but the establishment of reliable diagnostic methods of metastasis is essential. Development of new biomarkers is also necessary to select patients who are more likely to benefit from nCRT .