The researchers determined whether the addition of preoperative radiotherapy increases the benefit of total mesorectal excision in patients with resectable rectal cancer.
They reported their findings in the latest issue of the New England Journal of Medicine.
A total of 1861 patients were randomly assigned either to preoperative radiotherapy (5 Gy on each of five days) followed by total mesorectal excision (924 patients), or to total mesorectal excision alone (937 patients).
The trial was conducted with the use of standardization and quality-control measures to ensure the consistency of the radiotherapy, surgery, and pathological techniques.
Of the 1861 patients, 1805 were eligible to participate.
The overall rate of survival at two years among the eligible patients was 82.0% in the group assigned to both radiotherapy and surgery, and 81.8% in the group assigned to surgery alone.
Among the 1748 patients who underwent a macroscopically complete local resection, the rate of local recurrence at two years was 5.3%. The rate of local recurrence at two years was 2.4% in the radiotherapy-plus-surgery group and 8.2% in the surgery-only group.
| Local cancer recurrence rate at 2 years:|
Radiotherapy and surgery 2.4%
Surgery alone 8.2%
|New England Journal of Medicine|
Author Ellen Kapiteijn, of the Leiden University Medical Center, the Netherlands, concluded on behalf of the group, "Short-term preoperative radiotherapy reduces the risk of local recurrence in patients with rectal cancer who undergo a standardized total mesorectal excision."