Rectal cancer treatment: new insights on watch-and-wait and organ-preserving treatment strategies

In the Netherlands, each year about 3000 patients are diagnosed with rectal cancer, a tumour in the last part of the colon. Often, the treatment involves neoadjuvant treatment, radiotherapy sometimes in combination with chemotherapy, followed by surgery in which the whole rectum is removed. However, in a part of the patients treated with this neoadjuvant treatment, the tumour resolved completely, indicating a complete response. The Watch-and-Wait approach seems a suitable option for this group of patients. In this thesis, the quality of life of patients followed by a Watch-and-Wait approach is reported. Patients undergoing the Watch-and-Wait approach report a good quality of life, which is better compared to patients who underwent an operation. Thereby, a part of this thesis involves treatment options, which could be an alternative for an operation in patients with a near complete response. One of these alternative treatment options is a form of internal radiotherapy, contact brachytherapy. In older patients unfit for surgery, contact brachytherapy turns out to be a good alternative for surgery.