Depending on its location or stage, @entity5 may differ significantly. Before any treatment decision a careful work up is mandatory relying mainly on endoscopy and imaging (MRI). Surgery according to the TME principle is the cornerstone of treatment. Most of the time surgery is associated with external beam radiotherapy often combined with concurrent chemotherapy ( @entity416 ) according to the neoadjuvant regimen @entity51349 (5 weeks long). It is sometimes possible to escalate safely the dose of irradiation using contact X-ray brachytherapy 50 Kv or Iridium 192 interstitial brachytherapy. Adjuvant chemotherapy may be given in case of pejorative pathological findings but its benefit is not yet proven in contrast with @entity694 . Local recurrences are becoming unusual as is permanent APE surgery with permanent stoma. To reduce the risk of distant metastasis clinical trials are testing first line chemotherapy in T3-4 lesions. For early stage (T2-"small" T3) clinical trials try to achieve organ preservation. Intensification of @entity51349 either with more chemotherapy or radiation dose escalation using contact X-ray aim at achieving a clinical complete response followed by local excision or close surveillance.

[Peri-operative treatments for XXXX ].

@entity5 :: ('MESH:D009369', 'Disease') :: ['rectal cancer'] @entity51349 :: ('311', 'Gene') :: ['CAP 50'] @entity694 :: ('MESH:D003110', 'Disease') :: ['colon cancer'] @entity416 :: ('MESH:C110904', 'Chemical') :: ['capecitabine']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
