ADJUVANT TREATMENTS IN RESECTABLE RECTAL-CANCER - PREOPERATIVE RADIOTHERAPY, POSTOPERATIVE RADIOTHERAPY CHEMOTHERAPY OR NOTHING

In addition to curative surgical resection, which remains the treatmen t of choice in rectal cancer, are there any other effective adjuvant t reatments capable of increasing the life expectancy of patients by dec reasing the frequency of local recurrences and distant metastases ? An alysis of the results and clinical arguments in favour of adjuvant tre atments demonstrates the efficacy of preoperative radiotherapy which d ecreases the pelvic recurrence rate in patients with T2T3T4NxM0 tumour s. Postoperative administration of a combination of radiotherapy and c hemotherapy (5-FU, methyl CCNU) also improved the survival rate and di sease-free interval in patients operated for rectal cancer. However, t he adverse effects and toxicity of this adjuvant treatment limit its r outine administration. Lastly, the efficacy of postoperative radiother apy and postoperative chemotherapy, administered separately, has not b een clearly demonstrated to date.