Session Item

We can distinguish different historical periods since the 1970s in the treatment of rectal cancer with regard to the integration of radiotherapy with surgery and chemotherapy, in which the doses, volumes, fractionations, and timing used have changed according to evidence from the literature and improvements in the technologies and procedures of the various disciplines.

The following periods can be identified: pioneering, which runs from the 1970s to the mid-1980s in which there were few centers in the world in which radiotherapy was used in the integrated treatment of rectal cancer; proof-of-concept, up to the mid-1990s in which the first benefit studies, mainly single-center, appeared;  consolidated evidence, from the mid-1990s to 2010, in which the main evidences were consolidated through cooperative studies, which still constitute the reference of the treatment of rectal cancer; emerging questions, from 2010 to the present time, in which the issues of reduction and intensification of combination therapies based on risk factors, the arrival of molecular profiles, and digital modeling are being addressed.

For each of these periods, the salient features of radiotherapy modalities and the main evidence of clinical benefits for patients will be analyzed, also drawing on the 40-year experience of their center.