The management of rectal cancer has been changing during the last few years. Rates of local control and distant relapses have been improving, and rates of abdominoperineal amputations are decreasing, as well. These gains are associated with a multidisciplinary approach, personalizing treatment according to better staging and indication of pre-operative treatment. One of the main goals of neoadjuvant treatment in rectal cancer is to achieve complete response and avoid definitive colostomies. However, the risk of non-operative strategies is still related to the limitations of the current tools for response assessment and failure on detection residual disease. Improvements in the tools for assessment of response to chemotherapy or radiation therapy are crucial to rectal cancer management.
Rectal cancer is a high incidence disease, and, despite improvements in survival rates, is still associated with high morbidity and low quality of life. Although surgery is historically considered the main modality of treatment with curative intent, the role of radiation and chemotherapy has become more important during the last years. The better understanding of the role of pathologic complete response to neoadjuvant chemoradiation have allowed the evolution of organ preservation strategies, known as watch and wait, avoiding unnecessary abdominoperineal amputations. On the other hand, the risk of the non-operative strategies remains on the failure in the detection of residual disease after neoadjuvant treatment. The limitations of the current tools for assessment of response, based on clinical, endoscopic and imaging methods, are responsible not only for the wrong interpretation of a clinical complete response, but also for the misinterpretation of clinical residual disease, leading to an unnecessary surgery. Evolutions in assessment of response to radiation and chemotherapy are one of the most important areas of research, in gastrointestinal oncology. Clinical, translational and basic research can lead to the improvement of the current endoscopic and imaging exams, as well as the finding or development of new predictive biomarkers of response.
The scope of this Research Topic is to invite and stimulate studies in prediction of response to neoadjuvant chemoradiation in rectal cancer, especially in determining complete response, which can make organ-preservation strategies more precise and safer. We encourage the following types of manuscripts:
1. Translational studies for discovering or validating predictive biomarkers of response.
2. Basic research in mechanisms of resistance or sensitivity of rectal cancer to radiation therapy or chemotherapy.
3. Clinical studies, with prospective data, in validating predictive biomarkers of response.
4. Clinical studies, with prospective data, in endoscopic new tools and criteria for response assessment.
Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in Frontiers in Oncology.
The management of rectal cancer has been changing during the last few years. Rates of local control and distant relapses have been improving, and rates of abdominoperineal amputations are decreasing, as well. These gains are associated with a multidisciplinary approach, personalizing treatment according to better staging and indication of pre-operative treatment. One of the main goals of neoadjuvant treatment in rectal cancer is to achieve complete response and avoid definitive colostomies. However, the risk of non-operative strategies is still related to the limitations of the current tools for response assessment and failure on detection residual disease. Improvements in the tools for assessment of response to chemotherapy or radiation therapy are crucial to rectal cancer management.
Rectal cancer is a high incidence disease, and, despite improvements in survival rates, is still associated with high morbidity and low quality of life. Although surgery is historically considered the main modality of treatment with curative intent, the role of radiation and chemotherapy has become more important during the last years. The better understanding of the role of pathologic complete response to neoadjuvant chemoradiation have allowed the evolution of organ preservation strategies, known as watch and wait, avoiding unnecessary abdominoperineal amputations. On the other hand, the risk of the non-operative strategies remains on the failure in the detection of residual disease after neoadjuvant treatment. The limitations of the current tools for assessment of response, based on clinical, endoscopic and imaging methods, are responsible not only for the wrong interpretation of a clinical complete response, but also for the misinterpretation of clinical residual disease, leading to an unnecessary surgery. Evolutions in assessment of response to radiation and chemotherapy are one of the most important areas of research, in gastrointestinal oncology. Clinical, translational and basic research can lead to the improvement of the current endoscopic and imaging exams, as well as the finding or development of new predictive biomarkers of response.
The scope of this Research Topic is to invite and stimulate studies in prediction of response to neoadjuvant chemoradiation in rectal cancer, especially in determining complete response, which can make organ-preservation strategies more precise and safer. We encourage the following types of manuscripts:
1. Translational studies for discovering or validating predictive biomarkers of response.
2. Basic research in mechanisms of resistance or sensitivity of rectal cancer to radiation therapy or chemotherapy.
3. Clinical studies, with prospective data, in validating predictive biomarkers of response.
4. Clinical studies, with prospective data, in endoscopic new tools and criteria for response assessment.
Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in Frontiers in Oncology.