Actual concept for treatment of locally advanced rectal cancer: review

Since the early 1980s, we have witnessed the evolution of the role and place of radiation therapy in the treatment of rectal cancer. Currently, the "gold standard" treatment of locally advanced rectal cancer (LARC) is a multimodal approach including preoperative systemic anti- tumor drug therapy, chemoradiation and surgery. In this review, we have attempted to reflect the development of treatment paradigms for LARC.Various studies of the complex treatment of LARC have consistently demonstrated the efficacy of combination of surgical treatment with radiation therapy. The role of adjuvant chemotherapy on the basis of published studies remains controversial, while the use of total neoadjuvant therapy (TNT) in a multimodality approach in the treatment of patients with LARC has contributed to a reduced risk of distant metastasis and an increased rate of organ preserving surgery. Given the fact that the treatment options for LARC are rapidly changing, clinicians should carefully tailor treatment strategies for each patient.