Which side effects should be described to patients before neoadjuvant radio-chemotherapy treatment?

Chemotherapy and irradiation of organs adjacent to the target volumes are associated with significant acute gastrointestinal and genito-urinary toxicity and a high rate of post-operative complications and late toxicities. Assessing radiochemotherapy-related side-effects is hard because inter-study comparisons may be hampered by use of different toxicity scales, cohort sizes, study time-points, and study focus which may analyse, for example, only single side effects and their grades or all side-effects according to grade. Moreover, some side effects were under-analysed and under-reported. Finally, while increased early toxicity has been recognized in all trials, data are less clear about late toxicity. With the aim of improving the rectal cancer patient’s relationship with the radiation oncologist in the pre-treatment consultation this chapter answers the most common questions asked by a candidate for neo-adjuvant radio-chemotherapy.