The Use of Radiotherapy in Rectal Cancer

There has been considerable effort over the last three decades to investigate the role of radiation in rectal cancer. Until the mid 1990’s randomised controlled trials included a standard arm of surgery alone. Today, however, there is unequivocal evidence that adjuvant radiation reduces the risk of local recurrence in resectable rectal cancer. Current controversy relates to the sequencing with respect to surgery, the choice of radiation schedule and the benefits of concurrent chemotherapy. At the same time there have also been important improvements in pelvic preoperative imaging, surgical technique, and histopathological analysis of the resected specimen that will require further randomised trials in order to refine the role of radiation in this new “era.”