Management of Locally Unresectable Rectal Cancer

Abstract

The standard treatment for locally advanced/unresectable rectal cancer is preoperative radiation therapy followed by surgery. The primary goals of the preoperative treatment are to convert the cancer to a resectable status and to decrease the incidence of local failure. Phase I/II non-randomized data suggest that the most effective treatment is preoperative combined modality therapy followed by maximal surgical resection and intraoperative radiation therapy. In patients who cannot receive preoperative therapy, the use of maximal surgical resection plus intraoperative radiation therapy may be of benefit, however, it remains investigational.