Radiotherapy of locally recurrent rectal cancer        GAO Xian-shu, LI Hong-zhen. Department of Radiation Oncology, Peking University First Hospital, Beijing 100034, China
Corresponding author: LI Hong-zhen, E-mail：doclee0134@163.com
Abstract    Local recurrence is the most common clinical failure pattern of rectal cancer, especially in stage II/III rectal cancer cases. The prognosis of postoperative recurrence is poor. To prevent recurrence, related studies on adjuvant/neoadjuvant chemoradiotherapy of locally advanced rectal cancer after surgery started in the 1970s. A large number of clinical trial results showed that preoperative and postoperative adjuvant/neoadjuvant chemoradiotherapy of locally advanced rectal cancer may reduce local recurrence, improve sphincter rate and survival. The pattern of multiple discipline treatment has become an evidence-based medicine I class as a standard treatment options of locally advanced rectal cancer. Chemoradiotherapy of locally recurrent rectal cancer has not yet achieved a high level of evidence-based medicine. NCCN guidelines recommend against recurrent rectal cancer patients should be performed multidisciplinary and comprehensive treatment. For isolated recurrent pelvic or anastomosis, if patients have not received the full amount of radiation, the most appropriate treatment is preoperative radiotherapy, concurrent chemotherapy. In conditional medical institutions, preoperative neoadjuvant chemoradiotherapy plus surgery and intraoperative radiotherapy may be considered.