Carolyn Vachani, RN, MSN, AOCN
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: October 25, 2005
This study examined patients with T3 or T4 rectal adenocarcinoma with no metastases. Patients were assigned to receive either preoperative radiation (RT) or preoperative radiation and 4 cycles of chemotherapy with 5-FU and leucovorin (CT-RT). The results show that the CT-RT group had more complete surgical resections and fewer instances of recurrence in the rectum, but had slightly higher toxicity from treatment (diarrhea, skin issues). There was no difference between the groups in overall survival or ability to have sphincter-sparing surgery. The improvements in local recurrence and surgical resection make radiation with concurrent chemotherapy the standard of care for these patients. A second trial (NSABP R01) has also confirmed these findings.