Neoadjuvant Therapy Protocols for Locally Advanced Rectal Cancer

The treatment of locally advanced rectal cancer requires a multidisciplinary approach, including surgery, chemotherapy, and Radiation Oncology. One of the most effective strategies in managing this type of cancer is the use of neoadjuvant therapy, which involves administering treatment before surgery to reduce tumor size and improve surgical outcomes.

There are different neoadjuvant therapy protocols, which vary in their combination of chemotherapy and radiation. The most traditional regimen is the radiotherapy and chemotherapy protocol using 5-fluorouracil (5-FU) or capecitabine. This treatment is administered over several weeks before surgery, with the goal of shrinking the tumor to facilitate easier resection with smaller margins of invasion.

A commonly used regimen is the concurrent chemotherapy and radiotherapy protocol, which has demonstrated local control rates of over 70%. In this regimen, radiotherapy is given alongside chemotherapy, which helps sensitize tumor cells to the effects of radiation. Studies have shown that this approach not only improves local control of the cancer but also increases the possibility of preserving the anal sphincter, avoiding the need for a permanent colostomy in many patients.

Another popular regimen is the intensified neoadjuvant chemotherapy with radiotherapy protocol, which is used in patients with more advanced rectal cancer. This approach has shown local control rates exceeding 80% and is associated with a higher likelihood of achieving an R0 resection, meaning surgery with no residual tumor margins.

The rates of overall control have also improved with the use of neoadjuvant therapy. In patients treated with radiotherapy and chemotherapy prior to surgery, the 5-year survival rate reaches up to 70-80%, depending on the stage of cancer and the response to treatment.

In Costa Rica, Dr. Rolando Loría Ruiz, a Radiation Oncologist, has led the use of these modern approaches in treating rectal cancer, significantly improving patient outcomes. Through his website www.drrolandoloria.com, Dr. Loría provides detailed and reliable information about available treatments and how they can improve survival and disease control rates.

The combination of therapies and personalized treatment planning are key to the success of managing locally advanced rectal cancer, leading to more favorable outcomes in both local and overall disease control.