RADIOTHERAPY IN ADDITION TO RADICAL SURGERY IN RECTAL-CANCER

In order to lower unacceptably high local failure rates after surgery reported as curative for rectal cancer, perioperative radiotherapy has been extensively investigated, The collected information from a numbe r of controlled trials indicates that the proportion of local recurren ces is reduced to less than half when radiotherapy at moderately high doses is given preoperatively, This reduction in local failure rates i s not seen after postoperative radiotherapy, even if higher doses have been used, Possibly, there is also a slight positive influence on sur vival from preoperative radiotherapy, Improved survival has been seen also in trials using postoperative radiotherapy, but then only when co mbined with chemotherapy. With proper dose planning, sufficiently high doses can be given preoperatively with little if any increase in post operative mortality, Thus, although published knowledge is still rathe r limited, a properly planned preoperative radiotherapy seems to infli ct small bowel and other complication rates, that are less than when r adiotherapy of similar efficacy against the tumour is given postoperat ively.