Radiotherapy in rectal cancer and long time interval before surgery.

What is it about?

This research summarizes the 5-year results of Krakow Rectal Cancer Trial - the second trial conducted in Poland (after Polish Trial) on combined rectal cancer treatment.The 5-year survival rate in patients operated on 7-10 days after irradiation was 63%, whereas in those operated on after 4-5 weeks, it was 73%-the difference was not statistically significant (log rank, p = 0.24). A statistically significant increase in 5-year survival rate was observed only in patients with downstaging after radiotherapy-90% in comparison with 60% in patients without response to neoadjuvant treatment (log rank, p = 0.004). A lower rate of systemic recurrence was observed in patients operated on 4-5 weeks after the end of irradiation (2.8% vs. 12.3% in the subgroup with a shorter interval, p = 0.035). No differences in local recurrence rates were observed in both subgroups of irradiated patients (p = 0.119). The longer time interval between radiotherapy and surgery resulted in higher downstaging rate (44.2% vs. 13% in patients with a shorter interval, p = 0.0001).

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Photo by National Cancer Institute on Unsplash

Photo by National Cancer Institute on Unsplash

Why is it important?

It is one of the first studies on long-term interval between short-course preoperative radiotherapy and surgery (5x5 Gy). The other trial that focuses on this topic is Stockholm III Trial. Our study compares short (7-10 days) and long interval (4-5 weeks) between the end of radiotherapy and surgery (total mesolectal excision).

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