Advantages and disadvantages of preoperative and postoperative chemoradiotherapy for rectal cancer

Rectal cancer is caused by the malignant transformation of rectal tissue cells. With the improvement of the quality of life, the incidence of rectal cancer has increased year by year. Only by understanding the advantages and disadvantages of preoperative and postoperative chemotherapy and radiotherapy for rectal cancer can we implement a reasonable treatment plan in clinical treatment to achieve the best treatment effect.

Advantages of preoperative chemoradiotherapy for rectal cancer:

1. The primary lesion shrinks after radiotherapy and chemotherapy, increasing the chance of anal preservation surgery; 2. It increases the sensitivity of tumor cells to radiotherapy.

Disadvantages of preoperative chemoradiotherapy for rectal cancer:

1. Prolong the waiting time for surgery; 2. Because there may be micro-metastases to other organs before surgery, and radiotherapy and chemotherapy may lead to low immunity of the body, which may lead to the enlargement of metastatic lesions; 3. It may increase the incidence of postoperative complications; 4. There is a possibility of over-diagnosis and treatment.

Advantages of postoperative chemoradiotherapy for rectal cancer:

Relatively accurate and individualized chemoradiotherapy can be implemented based on the results of intraoperative exploration and postoperative pathological diagnosis.

Disadvantages of postoperative chemoradiotherapy for rectal cancer:

Intraoperative manipulation may cause the small intestine to adhere to the pelvic cavity, thereby causing it to be damaged by radiation during radiotherapy.

Radiotherapy has its pros and cons. In clinical practice, a specific comprehensive treatment plan can be implemented according to the specific situation of the patient. For example, for patients with rectal cancer diagnosed as T3 and (or) N1-2 by ultrasound, surgery should be performed first, followed by adjuvant comprehensive treatment including radiotherapy; for patients with rectal cancer diagnosed as T3 by ultrasound or clinical T4, adjuvant treatment (including radiotherapy or chemoradiotherapy) can be performed before surgery, followed by surgery, and adjuvant comprehensive treatment can be added after surgery; for individual early localized tumors, simple intracavitary radiotherapy can be performed; for patients with early rectal cancer, a local surgical resection combined with radiotherapy can be performed, mainly to increase the chance of retaining the anus.