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World J Gastroenterol. Sep 7, 2019; 25(33): 4850-4869
Published online Sep 7, 2019. doi: 10.3748/wjg.v25.i33.4850
Neoadjuvant radiotherapy for rectal cancer management
Gerard Feeney, Rishabh Sehgal, Margaret Sheehan, Aisling Hogan, Mark Regan, Myles Joyce, Michael Kerin
Gerard Feeney, Rishabh Sehgal, Aisling Hogan, Mark Regan, Myles Joyce, Michael Kerin, Department of General/Colorectal Surgery, Galway University Hospital, Galway H91 YR71, Ireland
Margaret Sheehan, Department of Histopathology, Galway University Hospital, Galway H91 YR71, Ireland
Author contributions: All authors contributed equally to this paper. All authors had equal input in conception, literature review, drafting, editing and final approval of the paper.
Supported by NBCRI, Symptomatic Breast Unit, University Hospital Galway.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior authors or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Gerard Feeney, MBChB, Doctor, Department of General/Colorectal Surgery, Lambe Institute, Galway University Hospital, Newcastle Road, Galway H91 YR71, Ireland. g.feeney3@outlook.com
Telephone: +353-91-524222
Received: May 9, 2019
Peer-review started: May 10, 2019
First decision: July 21, 2019
Revised: July 28, 2019
Accepted: August 7, 2019
Article in press: August 7, 2019
Published online: September 7, 2019
Processing time: 121 Days and 6.8 Hours
Core Tip

Core tip: Neoadjuvant radiotherapy aims to downstage tumours for a more effective oncological resection. Studies have shown that both long and short course pre-operative radiotherapy confers benefits to local recurrence. Some patients completely respond to radiotherapy and have been enrolled in surveillance programmes without undergoing surgery. It is essential to be aware of the disadvantages associated with radiotherapy. Radiation therapy increases the risk of anorectal and genitourinary dysfunction which have a deleterious impact on quality of life. Thus it is imperative to accurately identify patients who are likely to benefit from neoadjuvant radiotherapy in order to minimise morbidity and improve patient outcomes.