Some rectal cancer patients may safely avoid radiation: New research

Some patients with locally advanced rectal cancer may be able to safely forgo radiation before surgery to remove tumors, according to research published June 4 in The New England Journal of Medicine and the Journal of Clinical Oncology. 

Researchers from New York City-based Memorial Sloan Kettering Cancer Center and Boston-based Dana-Farber Brigham Cancer Center presented their findings during the American Society of Clinical Oncology's 2023 Annual Meeting, which were based on a phase 3 trial of 1,194 patients enrolled from June 2012 to December 2018. 

In the trial, patients who had rectal cancer that spread to nearby tissue or lymph nodes were randomly assigned to receive the standard six-week treatment of chemoradiation therapy before surgery, or 12 weeks of the chemotherapy combination FOLOX with radiation therapy "only if/when tumors did not shrink by 20 percent or more." Overall survival, disease-free survival and local recurrence were similar among the two treatment groups after five years, the findings showed. 

"The results of this practice changing study show that it is safe and effective to treat some locally advanced rectal cancer with preoperative chemotherapy and use chemoradiation therapy selectively, rather than administer chemoradiation to all patients," Deborah Schrag, MD, lead study author and chair of the department of medicine at MSK, said in a news release. "This gives patients a new standard of care that has the potential to reduce side effects and, in some cases, may make treatment more convenient."

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