Altered fractionation short-course radiotherapy for stage II-III rectal cancer: a retrospective study

Radiat Oncol. 2020 May 14;15(1):111. doi: 10.1186/s13014-020-01566-8.


Purpose: To report the long-term outcomes of neoadjuvant altered fractionation short-course radiotherapy in 271 consecutive patients with stage II-III rectal cancer.

Patients and methods: This was a retrospective single institution study with median follow-up of 101 months (8.4 years). Patients who were alive at the time of analysis in 2018 were contacted to obtain functional outcome data (phone interview). Radiotherapy consisted of 25 Gy in 10 fractions of 2.5 Gy administered twice daily. Median time interval to surgery was 5 days.

Results: Local relapse was observed in 12 patients (4.4%) after a median of 28 months. Overall survival after 5 and 10 years was 73 and 55.5%, respectively (corresponding disease-free survival 65.5 and 51%). Of all patients without permanent stoma, 79% reported no low anterior resection syndrome (LARS; 0-20 points), 9% reported LARS with 21-29 points and 12% serious LARS (30-42 points).

Conclusion: The present radiotherapy regimen was feasible and resulted in low rates of local relapse. Most patients reported good functional outcomes.

Keywords: Low anterior resection syndrome (LARS); Neoadjuvant altered fractionation short-course radiotherapy; Stage II-III rectal cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Dose Fractionation, Radiation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods
  • Neoadjuvant Therapy / mortality
  • Neoplasm Recurrence, Local / epidemiology
  • Radiotherapy, Adjuvant / methods*
  • Radiotherapy, Adjuvant / mortality
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / radiotherapy*
  • Retrospective Studies
  • Treatment Outcome