title: A single-centre experience of chemoradiotherapy for rectal cancer: is there potential for nonoperative management?
abstract: OBJECTIVE
  The aim of the study was to assess the outcome of patients who received chemoradiotherapy (CRT) for locally advanced rectal cancer, specifically those with complete clinical response (CCR) and who were then managed nonoperatively with a 'Watch and Wait' follow-up protocol.
  
  
  METHODS
  A retrospective study was carried out of patients undergoing preoperative CRT for rectal cancer, conducted in a district general hospital managing rectal cancer through the multidisciplinary team process.
  
  
  RESULTS
  Forty-nine patients received preoperative CRT over a 5-year period (2004-2009). Twelve (24%) were considered potentially to have had a complete response on MRI. Of these, six subsequently had clinical evidence of residual disease, leading to surgery (mean time to surgery, 24 weeks; range, 12-36 weeks). The remaining six had CCR, avoiding surgery (mean follow up, 26 months; range, 12-45 months), with all six patients disease free to date. A further six patients had complete pathological response (CPR) following surgery after comprehensive histopathological assessment of the specimen.
  
  
  CONCLUSIONS
  In this consecutive series of patients with locally advanced rectal cancer treated with CRT, 12% demonstrated a CCR and have been actively managed conservatively, thereby avoiding surgery. With further improvements in diagnostic assessment of response to CRT, this figure may rise.
authors.affiliation: Exeter Colorectal Unit, Department of Oncology, Royal Devon & Exeter Hospital, Barrack Road, Exeter, Devon, EX2 5DW, UK.
authors.forename: R S J
authors.initials: RS
authors.lastname: Dalton
authors.forename: R
authors.initials: R
authors.lastname: Velineni
authors.forename: M E
authors.initials: ME
authors.lastname: Osborne
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: S
authors.initials: S
authors.lastname: Harries
authors.forename: A S
authors.initials: AS
authors.lastname: Gee
authors.forename: I R
authors.initials: IR
authors.lastname: Daniels
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000069287:Capecitabine; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil