Clinical outcome in 520 consecutive Danish rectal cancer patients treated with short course preoperative radiotherapy

Abstract 

Aim

The purpose of this study was to analyse the results of preoperative short course radiotherapy in a consecutive, national cohort of patients with rectal cancer.

Methods

Through a validated, prospective national database we identified 520 Danish patients who presented with high-risk mobile tumours in the lower two thirds of the rectum and were referred for preoperative radiotherapy with 5 × 5 Gy. The inclusion period was 56 months. Radiotherapy data was retrospectively collected.

Results

Of the 520 patients, 514 completed radiotherapy and 506 had surgery. Surgery was considered curative in 439 patients. The 3-year local recurrence rate was 4.0% (95% CI 2.5–6.5%) and the distant recurrence rate at 3 years was 18.7% (95% CI 15.4–22.5%). The 5-year disease free survival rate was 40.2% (95% CI 27.0–53.1%) and overall survival 50.4% (95% CI 36.1–63.1%). Most tumours (61%) were classified as T3 or T4 and 41% of the local recurrences occurred in patients with a fixed tumour at surgery.

Conclusion

This study confirms data from randomised studies that the short course 5 × 5 Gy regime is a feasible treatment for locally advanced rectal cancer even when applied in a population outside clinical trials.

Keywords: Rectal cancer, Preoperative radiotherapy, Short course, Clinical outcome