Short Course of Radiation Fights Rectal Cancer
Study Shows Five Days of Treatment Cuts Risk of Cancer’s Return
Standard Treatment in the U.S. continued...
"Waiting lets the tumor shrink" so less surrounding tissue needs to be removed, he says. Also, the longer course of radiation means a lower dose is given at each visit, he says.
"We're concerned the higher dose [used in The Netherlands] may lead to more long-term side effects such as bowel dysfunction that requires more surgery to fix the injured tissue," Willett says.
Nonetheless, "this is an important trial because it has stimulated a lot of other trials looking at different radiation schedules. It's getting us closer to the optimal way to treating locally advanced rectal cancer," he says.
New Surgical Technique
Marijnen says the introduction of a new surgical technique that is being used more and more in both the U.S. and Europe prompted the study.
In the past, "surgeons pulled out just the rectum. Then studies showed total mesorectal excision (TME), in which surgeons remove the whole rectum plus the fat around it, reduces the risk of local recurrence even further," she says.
However, the impact of giving radiation prior to TME had not been examined, Marijnen says.
"These results demonstrate that good surgery absolutely is necessary and then radiotherapy can definitely add to the prevention of local recurrence," she says.
Willett says the findings "show the need for continuing education so TME is integrated into standard practice."
Radiation therapy does carry risks, chiefly temporary fatigue and transient skin reactions similar to sunburns during treatment. Later, there is a very small risk of secondary cancer or radiation-induced heart or lung disease.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.