Updates on the addition of radiotherapy for patients with locally advanced rectal cancer

This study reviewed the role of the addition of radiation therapy (RT) for the treatment of locally advanced rectal cancer (LARC). Researchers suggested that radiation therapy during surgery is associated with a lower recurrence (when cancer comes back) rate. 

Locally advanced and locally recurrent rectal cancer are defined as high-risk disease. During surgery, doctors are challenged in not leaving cancer cells behind. RT given before surgery helps reduce the size of the tumor and reduces the chance of cancer cells spreading. However, this is not always achievable.  

Prior studies showed that RT during surgery improves outcomes in high-risk patients with fewer side effects. However, very little is known about spreading rates, survival benefits, and toxicity associated with this treatment.

This study reviewed 7 other studies including information about 833 patients with LARC. Of these, 422 underwent RT during surgery and 411 had external RT at a different time than surgery (control group). The main outcome measured was local recurrence between the two groups. 

Local recurrence was lower with RT during surgery (14.7%) when compared to the control group (21.4%). RT during surgery had a 45% lower risk of recurrence. No significant difference in survival rates was reported between groups.

There was no increase in complications after surgery between groups. 

This study concluded that radiation therapy during surgery reduces the risk of local recurrence in patients with LARC.

The studies analyzed were different and the way RT was delivered during surgery varied among studies. This may limit the conclusions.