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Radiation Therapy: Short Versus Long Course

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Rectal Cancer

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

A short-course radiation therapy regimen (5 × 5 Gy) delivered immediately prior to surgery and a conventionally fractionated chemoradiotherapy regimen with a 6–8-week interval prior to surgery are the most commonly used schedules of preoperative radiotherapy for resectable rectal cancer. These two schedules were compared in a small (N = 312) randomized trial. At a median follow-up of 4 years, the anterior resection rate, postoperative complication rate, late toxicity rate, and anorectal/sexual dysfunction rate did not differ between groups. Long-term oncological outcomes (including local control, overall and disease-free survival) were similar, despite more favorable postoperative pathologic findings in the chemoradiotherapy group (i.e., smaller tumors, lower stage of disease, higher rates of pathological complete response, and fewer patients with involved radial margins). The acute adverse radiation effects and compliance rates were better in the short-course radiation group. Other studies have suggested that a short-course preoperative radiation regimen with a 6–8–week interval to surgery is a valuable treatment option for elderly patients who are unfit for chemotherapy, including patients with unresectable rectal cancer where transabdominal surgery is mandated or patients with small tumors prior to full-thickness local excision.

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Author information

Authors and Affiliations

  1. Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland

    Krzysztof Bujko MD & Magdalena Bujko MD

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  1. Krzysztof Bujko MD
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  2. Magdalena Bujko MD
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Editor information

Editors and Affiliations

  1. Dept. Radiation Oncology, Duke University Medical Center, Durham, USA

    Brian G. Czito

  2. Dept. Radiation Oncology, Duke University Medical Center, Durham, USA

    Christopher G. Willett

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© 2010 Humana Press

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Bujko, K., Bujko, M. (2010). Radiation Therapy: Short Versus Long Course. In: Czito, B., Willett, C. (eds) Rectal Cancer. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-567-5_14

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  • DOI: https://doi.org/10.1007/978-1-60761-567-5_14

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-566-8

  • Online ISBN: 978-1-60761-567-5

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