Neoadjuvant radiotherapy in rectal cancer – less is more?

• DOI: 10.1111/codi.14863
• Publication Date: 2019-09-26T08:34:50Z
• Authors: N. Jootun; S. Sengupta; C. Cunningham; P. Charlton; M. Betts; A. Weaver; C. Jacobs; R. Hompes; R. Muirhead
• Keywords: Neoadjuvant Therapy; Chemoradiotherapy; Demographics; Salvage Surgery

Abstract Aim There is significant international variation in the use of neoadjuvant radiation prior to total mesorectal excision. The MERCURY group advocate selective chemoradiotherapy (CRT). We have performed a retrospective, single‐centre study patients treated with CRT, where only circumferential resection margin threatened, aim identifying whether more approach CRT provides acceptable local relapse rates (LRRs). Method All consecutive who underwent radical surgery for rectal adenocarcinoma over 5‐year period (2007–2012) Oxford University Trust were considered. Electronic hospital systems reviewed obtain patient and tumour demographics, treatment follow‐up information. classified into risk categories according National Institute Health Care Excellence guidance. Data analysed using Microsoft Excel R. Results Two hundred seventy‐two identified: 123, 89 60 high‐, intermediate‐ low‐risk categories, respectively. Seventy‐nine per cent those high‐risk group, 6% intermediate 5% CRT. overall LRR distant recurrence rate (DRR) 5.2% 17.8%, went straight was 2.0% had it 7.4%. DRR these two groups 8.5% 18.9%, Conclusion Our series demonstrates that margin‐threatening tumours, results an exceptionally low without disease. In routine clinical care, this strategy can minimize morbidity multimodal allow earlier introduction systemic therapy recurrence.