Neoadjuvant radiotherapy for rectal cancer management

Table 1 Impact of radiotherapy on local recurrence and survival

Study	n	Interventions	Local recurrence	Overall survival	5-yr disease free survival
Swedish Rectal Cancer Trial, NEJM, 1997[24]	1168	25 Gy in 5 fractions in one week surgery	27% 11% (P ≤ 0.001)	58% 48% (P = 0.004)	74% 65% (after nine years) (P = 0.002)
Dutch Rectal Cancer Trial, NEJM, 2001[25]	1861	25 Gy in one week TME surgery	2.4% 8.2% (P ≤ 0.001)	82% 81.8% (P = 0.2)	N/A
MRC CR-07, Lancet, 2009[26]	1350	25 Gy in one week TME surgery and adjuvant therapy	27 (674) = 4% 72 (676) = 10.7%	70.3% 67.9% (P = 0.4)	73.6% 66.7% (P = 0.013)
Sauer et al[27], NEJM, 2004	850	50.4 Gy over 5 wk with 5-FU TME surgery	6% 13%	76% 74%	68% 65%
Fryckholm et al[28], 2001	70	40 Gy and 5-FU 40 Gy	4% 35% (P = 0.02)	66% 38% (P = 0.03)	29% 18% (P = 0.3)
Stockholm III trial, 2017[33]	840	Short course Short course w/ delay Long course w/ delay	2.24% 2.8% 5.5%	73% 76% 78%	65% 64% 65%
Bujko et al[88], 2016	515	5 × 5 Gy and FOLFOX 50.4 Gy in 28 fractions w/ 5-FU	22% 21% (P = 0.82)	73% 64.5% (P = 0.055)	53% 52% (P = 0.74)
Trans-Tasman Oncology Group, 2012[89]	326	5 × 5 Gy in 1 wk 50.4 Gy in 5 wk	7.5% 4.4% (P = 0.24)	74% 70% (P = 0.62)	N/A
Wawok et al[90], 2018	51	5 × 5 Gy 50.4 Gy w/5-FU	35% 5% (P = 0.036)	47% 86% (P = 0.009)	N/A
German CAO/ARO/AIO-04 study, 2012[91]	1236	50.4 Gy w/ 5-FU (Control) 50.4 Gy w/5-FU and Oxaliplatin	4.6% 2.9%	88% 88.7%	71.2% 75.9%

TME: Total mesorectal excision; FU: Fluorouracil; FOLFOX: Folinic Acid, Fluorouracil, Oxaliplatin; 5-FU: 5-Fluorouracil.