Long-short radiation therapy before surgery is associated with better outcomes in stage 2 and 3 rectal cancer

This study compared the survival outcomes of patients with rectal cancer who underwent short- or long-course radiation therapy (RT). Researchers suggested that long-course RT was associated with greater tumor response and survival.

Colorectal cancer is the third most common cancer diagnosed in the United States. The standard treatment before surgery for stages 2 and 3 rectal cancer is chemotherapy combined with short- or long-course radiation therapy.

Prior studies showed how long-course RT is associated with decreased local recurrence (when the cancer comes back) when compared to chemotherapy and RT after surgery. Other studies showed that short-course RT before surgery is associated with lower recurrence rates at 2 years, compared to surgery alone.

However, it is still not clear how short- and long-course RT affects the survival of patients with rectal cancer.

This study included information about 564 patients with rectal cancer. They underwent either short-course RT (188) and long-course RT (376). Survival outcomes were measured.

Patients who underwent long-course RT were more likely to have tumor shrinkage when compared to the short-course RT group. Patients in the long-course RT group also had a shorter stay at the hospital (6 days) when compared to the short-course RT (8 days). The 90-day death rate in the long-course RT was also lower (1%) than in the short-course group (10%).

Patients in the long-course RT had a 50% improvement in the risk of death compared to those in the short-course group.

This study concluded that patients with rectal cancer who undergo long-course RT are likely to have a better survival when compared to the ones who have short-course RT before surgery.

Side effects, additional medical conditions, and quality of life were not assessed in this study. These are important factors in survival outcomes.