title: Preoperative conventional chemoradiotherapy versus short-course radiotherapy with delayed surgery for rectal cancer: results of a randomized controlled trial.
abstract: There still is no evidence which neoadjuvant therapy regimen for stage II-III rectal cancer is superior. The aim of this study was to compare results achieved after long-course chemoradiotherapy (CRT) with short-term radiotherapy (RT) followed by delayed surgery.
  
  
  
  A randomized trial was carried out between 2007-2013. One hundred fifty patients diagnosed with stage II-III rectal cancer were randomized into one of two neoadjuvant treatment arms: conventional chemoradiotherapy (CRT) and short-term radiotherapy (RT) followed by surgery after 6-8 weeks. Primary endpoints of this trial were downstaging and pathological complete response rate. Secondary endpoints were local recurrence rate and overall survival.
  
  
  
  The pathological complete response was found in 3 (4.4%) cases after RT and 8 (11.1%) after CRT (P = 0.112). Downstaging (stage 0 and I) was observed in 21 (30.9%) cases in RT group vs. 27 (37.5%) cases in CRT group (P = 0.409). Median follow-up time was 39.7 (range 4.9-79.7) months. 3-years overall survival (OS) was 78% in RT group vs. 82.4% in CRT group (P = 0.145), while disease-free survival (DFS) differed significantly - 59% in RT group vs. 75.1% in CRT group (P = 0,022). Hazard ratio of cancer progression for RT patients was 1.93 (95% CI: 1.08-3.43) compared to CRT patients.
  
  
  
  Three-years disease-free survival was better in CRT group comparing with RT group with no difference in overall survival.
  
  
  
  http://clinicaltrials.gov identifier NCT00597311. January 2008.
authors.affiliation: Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania. tadas.latkauskas@kaunoklinikos.lt.
authors.forename: Tadas
authors.identifier: 0000-0001-7641-2421
authors.initials: T
authors.lastname: Latkauskas
authors.affiliation: Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Henrikas
authors.initials: H
authors.lastname: Pauzas
authors.affiliation: Department of Oncology and Hematology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Laura
authors.initials: L
authors.lastname: Kairevice
authors.affiliation: Department of Oncology and Hematology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Aleksandras
authors.initials: A
authors.lastname: Petrauskas
authors.affiliation: Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Zilvinas
authors.initials: Z
authors.lastname: Saladzinskas
authors.affiliation: Department of Oncology and Hematology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Rasa
authors.initials: R
authors.lastname: Janciauskiene
authors.affiliation: Department of Anaesthesiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Jurate
authors.initials: J
authors.lastname: Gudaityte
authors.affiliation: Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Paulius
authors.initials: P
authors.lastname: Lizdenis
authors.affiliation: Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Saulius
authors.initials: S
authors.lastname: Svagzdys
authors.affiliation: Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Algimantas
authors.initials: A
authors.lastname: Tamelis
authors.affiliation: Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Dainius
authors.initials: D
authors.lastname: Pavalkis
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011300:Preoperative Care; D011878:Radiotherapy / Q000379:methods; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Chemoradiotherapy; Rectal cancer