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Rectal Cancer Outcomes Best With Short-Course Radiation
Date:3/5/2009

Even with latest surgical techniques, therapy should come first, studies suggest

THURSDAY, March 5 (HealthDay News) -- For people with operable rectal cancer, the most effective treatment is a short course of radiation therapy followed by "high-quality surgery," according to a new study.

Surgery is the standard treatment for rectal cancer, but just removing the tumor leaves a risk of cancer recurrence in the same area, according to background information. Previous research has shown that radiotherapy and chemotherapy after surgery can reduce the risk of recurrence. However, radiotherapy is costly and can cause long-term complications such as impaired bowel function, incontinence and sexual dysfunction.

The study involved 1,350 rectal cancer patients in the United Kingdom, Canada, South Africa and New Zealand. Professor Robert Steele, of Ninewells Hospital in Dundee, Scotland, and his colleagues randomly assigned the participants to receive five daily treatments of radiotherapy followed by surgery, or to have surgery followed by 25 treatments of chemo-radiotherapy.

Three years after treatment, 4.4 percent of those who had received radiotherapy before surgery had a local recurrence of the cancer, compared with 10.6 percent of those who had received radiotherapy after surgery. The disease-free survival rate after three years was 77.5 percent for people who had received pre-surgery radiotherapy and 72 percent for those who had gotten post-surgery radiotherapy. There was no significant difference in overall survival -- 157 deaths in the pre-surgery radiotherapy group and 173 deaths in the post-surgery group.

The findings were published in this week's issue of The Lancet.

Another study in the same issue of the journal found that recent improvements in surgical techniques have improved rectal cancer patient outcomes. Professor Phil Quirke, of the University of Leeds, in the United Kingdom, and
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