BASIC PRINCIPLES OF SURGICAL TREATMENT, THE ROLE OF RADIOTHERAPYAND ADJUVANT CHEMOTHERAPY IN PATIENTS WITH LOCALLY ADVANCED

Abstract

Colorectal cancer (CRC) is a malignant disease of the gastrointestinal tract. About 30% of cases occurin the rectum, primarily affecting people over 60 years of age. Screening programs for early detection of CRC are important for improving survival rates. Diagnostic methods include colonoscopy, endorectal ultrasound, and imaging techniques such as CT and MRI. Treatment for rectal cancer involves a combination of surgical methods,radiotherapy, and chemotherapy, which achieve better control and survival rate, reducing mortality and improvingquality of life. According to European recommendations, preoperative radiotherapy (RT) leads to better survival rateand a lower risk of local recurrence, as proven in numerous studies. Total neoadjuvant therapy (TNT) can achieve better results compared to standard neoadjuvant therapy, with a higher rate of complete pathological response. Adjuvant chemotherapy after tumor resection aims to reduce the risk of recurrence. It is recommended for patients in stages II and III, considering risk factors. Several studies demonstrate the benefits of applying neoadjuvant and adjuvant therapy to improve prognosis and disease control in patients with rectal cancer.