Radiation Therapy for Rectal Cancer: Executive Summary of an ASTRO Clinical Practice Guideline

PurposeThis guideline reviews the evidence and provides recommendations for indications appropriate technique dose of neoadjuvant radiation therapy (RT) in treatment localized rectal cancer.MethodsThe American Society Radiation Oncology convened a task force to address 4 key questions focused on use RT preoperative management operable cancer. These included RT, identification regimens, consideration nonoperative or local excision approach after chemoradiation, volumes techniques. Recommendations were based systematic literature review created using predefined consensus-building methodology system grading quality recommendation strength.ResultsNeoadjuvant is recommended patients with stage II-III cancer, either conventional fractionation concurrent 5-FU capecitabine short-course RT. should be performed preoperatively rather than postoperatively. Omission conditionally selected lower risk locoregional recurrence. Addition chemotherapy before chemoradiation recommended. Nonoperative if clinical complete response achieved patients. Inclusion rectum mesorectal, presacral, internal iliac, obturator nodes volume In addition, inclusion external iliac tumors invading an anterior organ structure, inguinal involving anal canal.ConclusionsBased currently published data, has proposed evidence-based regarding Future studies will look further personalize optimize outcomes life.