Neoadjuvant chemotherapy enables R0 resection of locally advanced rectal cancer in a patient with a previously irradiated pelvis

Pre-operative chemoradiation is frequently employed in an attempt to downstage locally advanced rectal cancer which threatens or involves the circumferential resection margin (CRM) on MRI scanning. We present a case where radiotherapy was contraindicated as the patient had previously been irradiated to a radical dose for prostatic adenocarcinoma. Neoadjuvant capecitabine and oxaliplatin were used to downsize the tumour to permit resection with a clear CRM.