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<p>Radiotherapy is an integral component of multimodal treatment for rectal cancer. Modern techniques such as intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT), magnetic resonance imaging-guided linear accelerator (MR-Linac), and adaptive concepts enable more precise and less toxic treatment, opening new pathways for individualized therapy. In particular, the combination with total neoadjuvant therapy (TNT) has significantly advanced the development of organ-preserving strategies. These approaches are gaining importance not only in early-stage tumors but also in cases of locally advanced rectal cancer. Studies such as OPRA, CAO/ARO/AIO-16, and OPERA demonstrate that long-term organ preservation without radical surgery is feasible in selected patients—offering both solid oncologic control and improved quality of life. The successful implementation of these strategies relies on structured follow-up and close interdisciplinary collaboration among radiation oncologists, medical oncologists, and surgical experts. Future studies are needed to refine risk stratification and further optimize the balance between oncologic safety, functional outcomes, and quality of life in a&#xa0;personalized manner.</p>

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Moderne Strahlentherapie des Rektumkarzinoms

  • 期刊论文

  • 发表日期：

    2025年8月28日

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  • Daniel Habermehl

摘要

Radiotherapy is an integral component of multimodal treatment for rectal cancer. Modern techniques such as intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT), magnetic resonance imaging-guided linear accelerator (MR-Linac), and adaptive concepts enable more precise and less toxic treatment, opening new pathways for individualized therapy. In particular, the combination with total neoadjuvant therapy (TNT) has significantly advanced the development of organ-preserving strategies. These approaches are gaining importance not only in early-stage tumors but also in cases of locally advanced rectal cancer. Studies such as OPRA, CAO/ARO/AIO-16, and OPERA demonstrate that long-term organ preservation without radical surgery is feasible in selected patients—offering both solid oncologic control and improved quality of life. The successful implementation of these strategies relies on structured follow-up and close interdisciplinary collaboration among radiation oncologists, medical oncologists, and surgical experts. Future studies are needed to refine risk stratification and further optimize the balance between oncologic safety, functional outcomes, and quality of life in a personalized manner.