Introduction: Standard treatment is achieving good local control for rectal cancer. Innovative approach is aiming at increasing conservative treatment.
Methodology: Strong evidence relies on randomized trials. Phase I and II trials are the method to evaluate advances.
Results: Preoperative radiotherapy with concurrent chemotherapy is the standard treatment for most of the T3 (4) tumors. To increase conservative treatment innovative neoadjuvant treatment achieving complete clinical response is a promising approach.
Conclusion: Well-conducted clinical trials are improving the standard treatments and are evaluating new hypotheses.