From a series of clinical trials in the last several decades, current treatment paradigms for locally advanced rectal cancer include: (1) preoperative long-course radiotherapy (RT) combined with radiosensitizing chemotherapy; (2) preoperative short-course RT alone followed by adjuvant postoperative chemotherapy; and (3) total neoadjuvant therapy with induction chemotherapy followed by chemoradiotherapy. Other strategies under active investigation in both institutional and cooperative trials include neoadjuvant chemotherapy alone without RT in select patients, total neoadjuvant therapy, watchful waiting after a clinical complete response as an alternative to surgical resection, and the use of different chemotherapeutic and targeted agents. The focus of this review is on established and novel therapeutic strategies for locally advanced rectal cancer.

中文翻译：

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局部晚期直肠癌：过去，现在和将来。

根据最近几十年的一系列临床试验，当前针对局部晚期直肠癌的治疗范例包括：（1）术前长程放疗（RT）结合放射增敏化学疗法；（2）术前短程放疗单独进行术后辅助化疗；（3）诱导化疗后进行放化疗的全新辅助治疗。在机构和合作试验中，正在积极研究的其他策略包括：仅对部分患者进行不采用RT的新辅助化疗，完全新辅助治疗，临床完全缓解后的观察等待以替代手术切除以及使用不同的化学治疗和靶向药物。本文的重点是针对局部晚期直肠癌的既定和新颖的治疗策略。