Preoperative vs postoperative radiotherapy in the management of rectal cancer: A systematic review

Purpose. The objective of this study is to review randomized clinical trials systematically that compare the outcomes of preoperative and postoperative radiotherapy in the management of rectal cancer regarding locoregional recurrance, disease free survival and overall survival.Methods. The relevant randomized clinical trials are searched via online databases such as Pubmed, Ebsco, and Proquest. RCTs publised in English between 2000 until 2020 are selected and reviewed systematically.Result. Locoregional recurrence at 5 years was statistically lower in preoperative radiotherapy group than in postoperative radiotherapy group based on two studies.  Disease free survival at 5-years was statistically higher in preoprative radiotherapy group than the postoperative one based on two studies. Overall survival at 5 years was not statistically significant between two groups for each study.Conclusion. Preoperative radiotherapy is superior to postoperative radiotherapy for controlling locoregional recurrence and disease free survival, but both are equal in overall survival.