Loading
The German rectal trial moved chemoradiation to before surgery: local recurrence halved, more sphincters were saved and toxicity fell, with survival unchanged.
CAO/ARO/AIO-94 randomised 823 patients with clinical stage II or III rectal cancer to fluorouracil-based chemoradiation (50.4 Gy) given before or after total mesorectal excision. Five-year local recurrence was 6 percent with preoperative and 13 percent with postoperative treatment; acute and long-term toxicity were lower, and sphincter preservation in low tumours doubled, with no difference in overall survival (Sauer and colleagues, New England Journal of Medicine 2004). Preoperative chemoradiation became the standard for locally advanced rectal cancer.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
823 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Local recurrence at 5 yearsprimary | Preoperative chemoradiation | 421 | 6% | - | - | - |
| Postoperative chemoradiation | 402 | 13% |
Shares Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Fluorouracil (5-FU), IMRT / IGRT (modern external beam) and the tag radiation-wave4.