Preoperative radiation theration therapy in rectal cancer.

This paper outlines progress being made in the use of preoperative irradiation as an adjunct to surgery in the management of cancer of the rectum and rectosigmoid. Studies have shown that the normal rectal mucosa has a marked capacity for repair during fractionated radiation treatments. There is evidence that the use of preoperative irradiation reduces the number of involved lymph nodes found at operation. No marked interference with the ability of the surgeon to perform an abdominal perineal resection has been observed. In patients who subsequently undergo such a procedure, there are some data indicating that longevity may be increased when surgery is supplemented with preoperative irradiation, although further comparative studies are needed. Two studies are now under way by national clinical investigative groups.