Opinion statement
There is significant debate regarding the optimal neoadjuvant regimen for resectable rectal cancer patients. Short-course radiotherapy, a standard approach throughout most of northern Europe, is generally defined as 25 Gy in 5 fractions over the course of 1 week without the concurrent administration of chemotherapy. Long-course radiotherapy is typically defined as 45 to 50.4 Gy in 25–28 fractions with the administration of concurrent 5-fluoropyrimidine-based chemotherapy and is the standard approach in other parts of Europe and the United States. At present, two randomized trials have compared outcomes for short course radiotherapy with long-course chemoradiation showing no difference in respective study endpoints. Late toxicity data are lacking given limited follow-up. Although the ideal neoadjuvant regimen is controversial, our current bias is long-course chemoradiation to treat patients with locally advanced, resectable rectal cancer.
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References and Recommended Reading
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Manisha Palta, Christopher G. Willett, and Brian G. Czito declare that they have no conflict of interest.
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Palta, M., Willett, C.G. & Czito, B.G. Short-Course versus Long-Course Chemoradiation in Rectal Cancer—Time to Change Strategies?. Curr. Treat. Options in Oncol. 15, 421–428 (2014). https://doi.org/10.1007/s11864-014-0296-2
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DOI: https://doi.org/10.1007/s11864-014-0296-2