Modern principles of neoadjuvant therapy for rectal cancer
https://doi.org/10.21294/1814-4861-2025-24-2-126-132
Abstract
Objective. The location of the rectum in the space limited by the rigid frame of the pelvic bones has determined the priority of combined modality treatment for locally advanced rectal cancer with a significant role of preoperative therapy. Over the past three decades, radiation therapy has become an increasingly integral component of neoadjuvant treatment of rectal cancer. Research activities aimed at increasing the effectiveness of perioperative radiotherapy in preventing local recurrence have been ongoing. Material and Methods. This article provides an overview of the results of current studies of various neoadjuvant therapy regimens for locally advanced rectal cancer, as well as promising options for optimizing preoperative irradiation. The search for publications on the topic of the review was performed using the Web of Science and PubMed databases. Out of 202 studies, 36 were selected for literature review. Results. The question of the advantage of large fraction radiotherapy over prolonged chemoradiotherapy still remains open. Improvements in neoadjuvant treatment outcomes in rectal cancer are associated with various options for increasing the radiation dose. In addition, the review examines the use of preoperative chemotherapy as an alternative to radiation therapy or as a component of combined modality treatment for rectal cancer. Conclusion. It is assumed that the strategy of total neoadjuvant therapy will not only improve local disease control, but also reduce the risks of systemic relapse. Currently, a multidisciplinary approach is of great importance in optimizing the treatment strategy for patients with rectal cancer.
About the Authors
A. M. Karachun
N.N. Petrov National Medical Research Center of Oncology of the Ministry of Health of Russia ; I.I. Mechnikov North-Western State Medical University of the Ministry of Health of Russia
Russian Federation
Russian Federation
Alexei M. Karachun, MD, DSc, Professor, Head of the Department of Abdominal Oncology; Professor, Department of Oncology
Researcher ID (WOS): AAC-4011-2019. Author ID (Scopus): 6505903635
68, Leningradskaya St., Pesochny, Saint Petersburg, 197758
41, Kirochnaya St., Saint Petersburg, 191015
D. V. Samsonov
N.N. Petrov National Medical Research Center of Oncology of the Ministry of Health of Russia ; S.M. Kirov Military Medical Academy
Russian Federation
Russian Federation
Denis V. Samsonov, MD, PhD, Associate Professor; Associate Professor, 2nd Department (Surgery For Advanced Medical Studies)
68, Leningradskaya St., Pesochny, Saint Petersburg, 197758
6, Akademika Lebedeva St., Saint Petersburg, 194044
S. N. Novikov
N.N. Petrov National Medical Research Center of Oncology of the Ministry of Health of Russia
Russian Federation
Russian Federation
Sergey N. Novikov, MD, DSc, Professor, Head of the Department of Radiotherapy
Author ID (Scopus): 7202404433
68, Leningradskaya St., Pesochny, Saint Petersburg, 197758
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For citations:
Karachun A.M., Samsonov D.V., Novikov S.N. Modern principles of neoadjuvant therapy for rectal cancer. Siberian journal of oncology. 2025;24(2):126-132. (In Russ.) https://doi.org/10.21294/1814-4861-2025-24-2-126-132
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