IMRT

Adverse effects of long-course chemoRT

 Radiation enteritis = primary acute/late side effect  German trial: preop chemoRT less toxic than postop (1)

 Acute grade ≥ 3 toxicity rate up to 5 times higher with the addition of 5-FU to preoperative RT as compared to preoperative RT alone (2)  Intensified chemotherapy + RT:

(1)Sauer et al., N Engl J Med 2004 (2)Gérard et al., J Clin Oncol 2006

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