Almost 80% of patients with early-stage rectal cancer avoided surgery for a year or longer when treated with chemoradiation in a randomized trial.The organ-preservation strategies of chemoradiation and radiotherapy were both associated with few adverse events without sacrificing oncologic control.Longer follow-up is needed to determine long-term disease control and safety.
Almost 80% of patients with early-stage rectal cancer remained surgery-free for a year or longer after treatment with chemoradiation therapy (CRT), a large randomized study showed.
Among 341 patients who chose not to have upfront surgery (total mesorectal excision, TME), 78.5% of those randomized to CRT remained TME-free at 12 months, as did 60% of the patients randomized to a short course of radiotherapy (RT) alone. Both organ-preserving strategies were associated with low rates of adverse events in the STAR-TREC study.
Though still early, the results support a response-adapted organ-preservation strategy, suggesting better 12-month outcomes with CRT, reported researchers led by Simon Bach, MD, of University College London, in Lancet Oncology.
Organ-preservation strategies for rectal cancer are not new, but most studies to date focused on "opportunistic" organ preservation, involving patients who received CRT as part of routine care for locally advanced disease to reduce the risk of pelvic recurrence after radical surgery, Bach told MedPage Today. In general, the studies showed that as many as 20% of patients had complete resolution of tumors with CRT and might have avoided surgery.
