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J Clin Oncol. 2005 Aug 20;23(24):5644-50.

Swedish Rectal Cancer Trial: long lasting benefits from radiotherapy on survival and local recurrence rate.

Author information

1
Department of Surgical Sciences and Oncology, Uppsala University Hospital, 751 85 Uppsala, Sweden. joakim.folkesson@surgsci.uu.se

Abstract

PURPOSE:

To evaluate the long-term effects on survival and recurrence rates of preoperative radiotherapy in the treatment of curatively operated rectal cancer patients.

PATIENTS AND METHODS:

Of 1,168 randomly assigned patients in the Swedish Rectal Cancer Trial between 1987 and 1990, 908 had curative surgery; 454 of these patients had surgery alone, and 454 were administered preoperative radiotherapy (25 Gy in 5 days) followed by surgery within 1 week. Follow-up was performed by matching against three Swedish nationwide registries (the Swedish Cancer Register, the Hospital Discharge Register, and the Cause of Death Register).

RESULTS:

Median follow-up time was 13 years (range, 3 to 15 years). The overall survival rate in the irradiated group was 38% v 30% in the nonirradiated group (P = .008). The cancer-specific survival rate in the irradiated group was 72% v 62% in the nonirradiated group (P = .03), and the local recurrence rate was 9% v 26% (P < .001), respectively. The reduction of local recurrence rates was observed at all tumor heights, although it was not statistically significant for tumors greater than 10 cm from the anal verge.

CONCLUSION:

Preoperative radiotherapy with 25 Gy in 1 week before curative surgery for rectal cancer is beneficial for overall and cancer-specific survival and local recurrence rates after long-term follow-up.

PMID:
16110023
DOI:
10.1200/JCO.2005.08.144
[Indexed for MEDLINE]
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