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Radiation Reduces Rectal Cancer Recurrence

Preoperative more effective than postoperative radiation

FRIDAY, Mar. 6 (HealthDay News) -- Preoperative radiation is more effective than postoperative radiation in reducing local recurrence in patients with rectal cancer, researchers report in the Mar. 7 issue of The Lancet.

David Sebag-Montefiore, from St. James's University Hospital in Leeds, United Kingdom, and colleagues randomly assigned 1,350 patients with operable rectal adenocarcinoma to short-course preoperative radiotherapy or initial surgery with selective postoperative chemoradiotherapy.

After a median follow-up of four years, the researchers found that 330 patients died and 99 developed local recurrence. Patients receiving preoperative radiotherapy had a significantly lower risk of local recurrence (hazard ratio, 0.39) and better disease-free survival (HR, 0.76), but similar overall survival (HR, 0.91), the author report.

"The main message of this study, that short-course radiation therapy reduces the local recurrence rate after surgery for rectal cancer, is not new," Robert D. Madoff, M.D., from the University of Minnesota in Minneapolis, writes in an accompanying editorial. "The next challenge is to understand which patient needs what therapy to maximize his or her chance for cure."

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