[Neoadjuvant approach for non-metastatic rectal cancer combining radiotherapy and chemotherapy. Biotargeted drugs].

Abstract:

:Neoadjuvant chemoradiotherapy is considered at the present time as the standard treatment of most T3-4 rectal cancer. In France a combination of radiotherapy (45 Gy/5 weeks) with concurrent capecitabine (1,600 mg/m2) is the most popular protocol. Randomized trials try to optimize this approach using new cytotoxic drugs and/or radiation dose-escalation. The introduction of biotargeted therapies (anti-EGFR or antiangiogenic) is an attractive field especially selecting the treatment according to K-ras mutation. For T2 and 'early T3' present studies are using neoadjuvant chemoradiation followed by transanal local excision in case of good tumor response. In frail elderly patients, a new trend is to use mainly exclusive irradiation to control the tumor and avoid the excessive toxicity of open surgery in this group of patients. As rectal cancer is presenting many different clinical situations, an individualised treatment appears justified.

journal_name

Bull Cancer

journal_title

Bulletin du cancer

authors

Gérard JP,Francois E,Deustch E,Rostom Y,Douar N,Benezery K,Milano G

doi

10.1684/bdc.2009.0838

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

321-8

issue

3

eissn

0007-4551

issn

1769-6917

pii

bdc.2009.0838

journal_volume

96

pub_type

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