Role of radiation therapy in neoadjuvant era in patients with locally advanced rectal cancer

Table 1 Randomized trials comparing the role of radiation therapy as preoperative treatment vs surgery alone in patients with locally advanced rectal cancer

Ref.	n	Treatment arms	Local recurrence	Overall survival
Kapiteijn et al[11], 2001 (the Dutch colorectal cancer group)	1861	Arm 1(924 patients): preoperative RT (5 Gy × 5 d) followed by TME	2 yr of follow-up	2-yr survival rate
			2.4% in the RT + S group	82.0% RT + S
		Arm 2 (937 patients): TME alone	8.2% S only group	81.8% S alone
			(P < 0.001)	(P = 0.84)
Pahlman[5], 1997 (Swedish rectal cancer trial)	1168	Arm 1 (553 patients): preoperative RT (25 Gy delivered in five fractions in 1 wk) followed by S	5 yr of follow-up	5-yr survival rate
			11% in the RT + S group	58.0% RT + S
		Arm 2 (557 patients): S alone	27% S only group	48.0% S alone
			(P < 0.001)	(P = 0.004)
van Gijn et al[14], 2011	1805	Arm 1 (897 patients): preoperative RT (5 Gy × 5 d) followed by TME	10 yr of follow-up	10-yr survival rate
			5% in the RT + S group	50% RT + S
		Arm 2 (908 patients): TME alone	11% S only group	40% S alone
			(P < 0.0001)	(P = 0.032)

TME: Total mesorectal excision; RT: Radiation therapy; S: Surgery.