title: Short-course versus long-course chemoradiation in rectal cancer--time to change strategies?
abstract: There is significant debate regarding the optimal neoadjuvant regimen for resectable rectal cancer patients. Short-course radiotherapy, a standard approach throughout most of northern Europe, is generally defined as 25 Gy in 5 fractions over the course of 1 week without the concurrent administration of chemotherapy. Long-course radiotherapy is typically defined as 45 to 50.4 Gy in 25-28 fractions with the administration of concurrent 5-fluoropyrimidine-based chemotherapy and is the standard approach in other parts of Europe and the United States. At present, two randomized trials have compared outcomes for short course radiotherapy with long-course chemoradiation showing no difference in respective study endpoints. Late toxicity data are lacking given limited follow-up. Although the ideal neoadjuvant regimen is controversial, our current bias is long-course chemoradiation to treat patients with locally advanced, resectable rectal cancer.
authors.affiliation: Duke University Medical Center DUMC, 3085, Durham, NC, 27710, USA, manisha.palta@duke.edu.
authors.forename: Manisha
authors.initials: M
authors.lastname: Palta
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Willett
authors.forename: Brian G
authors.initials: BG
authors.lastname: Czito
mesh_terms: D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D006801:Humans; D020360:Neoadjuvant Therapy; D012004:Rectal Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D013997:Time Factors