Between March 2018 and July 2021, 26 patients were treated with the concept of neoadjuvant radiotherapy (5 × 5 Gy) and delayed surgery (SRT-delay) for rectal cancer at Ruppin- Brandenburg University Hospital. All patients had locally advanced primary adenocarcinoma (≥uT3 or/and N+) in the lower or middle third of the rectum. In addition, patients with locally advanced upper third rectal cancer whose main tumor mass appeared caudal to the promontory on sagittal MRI view were included.
Patients were assigned to this form of neoadjuvant therapy because they either could not tolerate conventional neoadjuvant chemoradiation due to their comorbidities or refused chemotherapy.
Short-term neoadjuvant radiotherapy included five fractions of 5 Gy in one week (5 × 5 Gy), followed by an interval of about 8 weeks before surgery.
22 of the 26 patients underwent initial staging (CT, endoscopy, MRI) and complete re-staging before surgery. 4 of 26 patients had to be excluded from the study because of insufficient re-staging. In 2 of these 4 cases, inserted hip arthroplasties caused poor MRI quality. MRI was not possible in one patient, and re-staging endoscopy was not performed in the remaining patient.
The clinical data of the 22 patients enrolled in the study are shown inTable 1 .
The study was approved by the ethics committee of the Brandenburg Medical School (No. E-02-20210930).
Tumor downsizing after neoadjuvant therapy was assessed by comparing staging and re-staging data on MRI and endoscopy and by comparing initial staging data with pathological findings.
Patients were assigned to this form of neoadjuvant therapy because they either could not tolerate conventional neoadjuvant chemoradiation due to their comorbidities or refused chemotherapy.
Short-term neoadjuvant radiotherapy included five fractions of 5 Gy in one week (5 × 5 Gy), followed by an interval of about 8 weeks before surgery.
22 of the 26 patients underwent initial staging (CT, endoscopy, MRI) and complete re-staging before surgery. 4 of 26 patients had to be excluded from the study because of insufficient re-staging. In 2 of these 4 cases, inserted hip arthroplasties caused poor MRI quality. MRI was not possible in one patient, and re-staging endoscopy was not performed in the remaining patient.
The clinical data of the 22 patients enrolled in the study are shown in
The study was approved by the ethics committee of the Brandenburg Medical School (No. E-02-20210930).
Tumor downsizing after neoadjuvant therapy was assessed by comparing staging and re-staging data on MRI and endoscopy and by comparing initial staging data with pathological findings.
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