Radiation plus chemotherapy as adjuvant therapy for rectal cancer

The most common neo-adjuvant therapy for rectal cancer is chemotherapy and concurrent radiation therapy. In general, it is delivered pre-operatively for patients with clinical evidence of T3–4 disease or post-operatively in patients who have undergone surgery and have T3 and/or N1–2 disease. This chapter reviews the rationale and results for neo-adjuvant therapy, the selection process for pre-operative versus post-operative treatment, and new approaches and controversies.