Can radiation therapy be a radical method of treating lateral metastases in rectal cancer?

Introduction. One of the reasons for unsatisfactory local control of rectal cancer may be metastatic lesions of the lateral pelvic lymph nodes. Eastern and Western strategies for preventing local recurrence of this disease have developed in different directions. If in Japan lateral lymph node dissection has become a mandatory addition to total mesorectumectomy, the Western concept relies on the sanitizing effect of preoperative irradiation of possible regional metastases. Results. The article is a review of publications demonstrating the results of radiation exposure to the lymphatic collector of the lateral compartment of the pelvis in rectal cancer. The search for articles on the topic of the review was carried out using the Web of Science and PubMed databases. In the course of the literature analysis, 94 sources were studied, of which 30 were selected to form the review. Most of the presented publications indicate the need for surgical removal of enlarged lateral lymph nodes due to the inability of radiation therapy to reliably ensure complete regression of lymphogenous metastases. Conclusions. The currently available data do not allow us to consider radiotherapy as a radical method of treating lateral pelvic metastases. However, further study of options for increasing the radiation load on this area may, to some extent, limit surgical aggression towards this lymph collector.