Radiotherapy reducing local failure rates andimproving overall survival has a favorable impact on the primary treatment ofrectal cancer. However, radiation as an adjuvant therapy for that purpose andother pelvic malignances has been shown to increase long-term morbidity causingsevere rectal or vesical mucositis, sometimes stenosis, undistensibler rectumwith reduced capacity and/or anorectal dysfunction due lombosacralneuropathywith physiologic changes whose interaction remains poorly understood 60,63.Those iatrogenic outcomes stress the need for finding predictive factors forlocal recurrence to exclude patients with very high probability for cure withsurgery alone and to use optimized radiation techniques22,64.
