| Summary: | Preoperative chemoradiotherapy (pCRT) followed by total mesorectal excision is
the accepted standard treatment for patients with locally advanced rectal
cancer. The purpose of pCRT is to prevent the spread of viable tumor cells
within the local area during surgical procedures. Additionally, pCRT can
facilitate the resection of locally advanced tumors that are otherwise
challenging to remove, thereby enabling a radical resection. Although a
pathologic complete response is observed in fewer than 20% of patients, the
reasons for the variability in tumor response to pCRT are not fully understood.
Several techniques have been researched with the aim of improving the tumor
response to pCRT. These techniques include intensifying or combining
chemotherapy, either simultaneously or sequentially, increasing radiation dose,
modifying radiation mode or schedule, adjusting the interval between radiation
and surgery, and incorporating multiple agents to increase the efficacy of pCRT.
This review discusses various strategies that may improve tumor response
outcomes following pCRT.
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