High-dose segmental radiotherapy for rectal cancer is mainly applied to preoperative radiotherapy for stage II and III rectal cancer that can be completely resected initially, which can be applied in conjunction with immediate total mesenteric resection of the rectum to reduce the postoperative local recurrence rate, but the indications have to be strictly evaluated and have to be applied after multidisciplinary team discussion.
Preoperative conventional dose radiotherapy is suitable for all patients with stage II-III rectal cancer, which facilitates adequate tumor regression and complete resection, and also reduces the postoperative local recurrence rate, and the surgery is usually performed 2 weeks after radiotherapy, which is a longer time overall. Some of the patients with stage II-III rectal cancer that can be completely resected initially can be treated with high-dose fractionated preoperative short-course radiotherapy instead of conventional radiotherapy, with 1-week postoperative surgery.
The mode of high-dose fractionated short-course radiotherapy plus immediate total mesorectal excision is not as good as conventional radiotherapy in terms of adequate tumor regression, but the rate of postoperative local recurrence is similar, and it can shorten the overall treatment time, so it can be considered to be applied in the patients with stage II-III rectal cancer that can be initially completely resected by surgery.
High-dose fractionated radiotherapy for rectal cancer needs to be selected under physician’s guidance for indications and is recommended to be applied after multidisciplinary team discussion, so it is recommended that patients follow the doctor’s instructions.