Role of Oxaliplatin in the Neoadjuvant Concurrent Chemoradiotherapy in Locally Advanced Rectal Cancer: a Review of Evidence

ABSTRACT: The treatment of locally advanced rectal cancer (LARC) is a challenging situation for radiation oncologists and colorectal surgeons.

Most current approaches recommend neoadjuvant fluorouracil or capecitabine-based chemoradiotherapy followed by surgery as a standard

of care. Intensification of concurrent chemotherapy by adding oxaliplatin to fluorouracil or capecitabine backbone to get better outcomes is the

matter that has remained unresolved. In this review, we searched Medline and Google Scholar databases and selected 28 prospective phase

II and III clinical trials that addressed this question. We discussed the potential advantages and drawbacks of incorporating oxaliplatin into

concurrent chemoradiation therapy. We tried to define whether adding oxaliplatin to concurrent chemoradiation with excellent performance and

high-risk features benefits some subpopulations. The available literature suggests that by adding oxaliplatin there are some benefits in enhancing

response to neoadjuvant chemoradiotherapy, however, without any translated improvements in long-term outcomes including overall and

disease-free survival.