Short-course RT with delay to surgery recommended as alternative in rectal cancer

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Takeaway

  • All 3 treatment options yield similar oncological results.
  • Long-course radiotherapy with delay prolongs treatment time; postoperative complications were significantly reduced in short-course radiotherapy with delay vs immediate surgery.

Why this matters

  • Optimal radiotherapy fractionation and time between radiotherapy and surgery for rectal cancer remain unresolved.

Key results

  • Cumulative incidences of local recurrence or distant metastases did not differ significantly between the 3 treatment groups.
  • There were also no differences in overall or recurrence-free survival.
  • Acute radiation-induced toxicity occurred in <1% patients after short-course radiotherapy, 7% after short-course radiotherapy with delay, and 5% after long-course radiotherapy with delay.
  • Pooled analysis of short-course radiotherapy regimens demonstrated reduced risk for postoperative complications after short-course radiotherapy with delay.

Study design

  • Multicenter, randomized, noninferiority trial (Stockholm III) allocated pa...