Combined treatment of patients with rectal cancer with a high risk of tumor progression

In order to improve the treatment outcome of rectal cancer patients with a high risk of progression, a variant of neoadjuvant complex therapy based on a prolonged course of hypofractionated radiotherapy in combination with polyradiomodification and systemic polychemotherapy was developed. The use of this therapeutic variant allowed to balance the factors of high risk of progression and to achieve long-term treatment results comparable to the results of standard neoadjuvant chemoradiotherapy programs based on short intensive radiotherapy with the use of polyradiomodification in the prognostically more favorable group of patients with average risk of progression. It is associated with the strengthening of the carcinicidal effect, as evidenced by the detection of therapeutic pathomorphosis of 3-4 degrees in 76.1% of patients (35 out of 46). At the same time, a slight increase in the frequency of toxic manifestations did not serve as an obstacle to the full completion of the planned course of treatment, as all toxic manifestations were easily controlled by the prescription and administration of concomitant therapy.