Would you use standard neoadjuvant chemoradiation for a patient with advanced rectal cancer and a history of previous pelvic RT for another cancer?

No. We have to remember that the benefit of radiation in locally advanced rectal cancer is limited to a local control benefit; and must balance the risks/benefits as such. Moreover, there are T3 tumors with an uninvolved mesorectal fascia(1) where the role of radiation may be more limited; since a T...

In addition to increased R-resection, the benefit of chemoradiation is also in the treatment of non-TME nodes. The MERCURY trial and Deb Schrag's paper are in highly favorable patients (small, High T2, T3 / N0). I would not treat most of those patient with or without prior radiation. However, in the...