LAUSR

Treatment of locally advanced rectal cancer involves the combined use of chemotherapy and radiation therapy (RT). The current paradigm for treatment of rectal cancer is evolving, but traditional sequencing includes neoadjuvant chemoradiotherapy (CRT) and adjuvant chemotherapy. Radiation therapy regimens range from 45 to 50 Gy in 25 to 28 fractions to the rectum and pelvic lymph nodes. Concurrent infusional 5-FU or capecitabine is given as CRT improves tumor response and local control compared with RT alone in the neoadjuvant setting. Adjuvant FOLFOX (a combination of 5FU, leucovorin, and oxaliplatin) or CapeOX (capecitabine replacing 5FU) are recommended regimens in appropriate clinical scenarios. Common acute RT toxicities include diarrhea, cystitis, or dermatitis based on treatment fields, and usually resolve without sequelae. However, late RT toxicities, such as chronic proctitis, stool incontinence, rectal