Tumour regression in the randomized Stockholm III Trial of radiotherapy regimens for rectal cancer
D Pettersson, E Lörinc, T Holm, H Iversen, B Cedermark, B Glimelius, A Martling, D Pettersson, E Lörinc, T Holm, H Iversen, B Cedermark, B Glimelius, A Martling
Abstract
Background: The Stockholm III Trial randomized patients with primary operable rectal cancers to either short-course radiotherapy (RT) with immediate surgery (SRT), short-course RT with surgery delayed 4-8 weeks (SRT-delay) or long-course RT with surgery delayed 4-8 weeks. This preplanned interim analysis examined the pathological outcome of delaying surgery.
Methods: Patients randomized to the SRT and SRT-delay arms in the Stockholm III Trial between October 1998 and November 2010 were included, and data were collected in a prospective register. Additional data regarding tumour regression grade, according to Dworak, and circumferential margin were obtained by reassessment of histopathological slides.
Results: A total of 462 of 545 randomized patients had specimens available for reassessment. Patients randomized to SRT-delay had earlier ypT categories, and a higher rate of pathological complete responses (11·8 versus 1·7 per cent; P = 0·001) and Dworak grade 4 tumour regression (10·1 versus 1·7 per cent; P < 0·001) than patients randomized to SRT without delay. Positive circumferential resection margins were uncommon (6·3 per cent) and rates did not differ between the two treatment arms.
Conclusion: Short-course RT induces tumour downstaging if surgery is performed after an interval of 4-8 weeks.
© 2015 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
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References
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Source: PubMed