ArticleAnnals of oncology : official journal of the European Society for Medical Oncology2024
Organ preservation after neoadjuvant long-course chemoradiotherapy versus short-course radiotherapy.
Article in Annals of oncology : official journal of the European Society for Medical Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Watch-and-Wait strategy for locally advanced rectal cancer after neoadjuvant chemoradiotherapy: a comprehensive review.Frontiers in oncology · 2026Pooled it
- Total neoadjuvant therapy based on short-course radiotherapy versus standard long-course chemoradiotherapy for locally advanced rectal cancer: a systematic review and meta-analysis of randomized controlled trials.Frontiers in oncology · 2024Pooled it
- Short-course versus long-course neoadjuvant chemoradiotherapy in patients with rectal cancer: long-term results of a randomized controlled trial.International journal of colorectal disease · 2025Trial
- De-escalated total neoadjuvant therapy for the non-operative management of rectal cancer: Results of the NOM-3/TNT prospective cohort study.Clinical and translational radiation oncology · 2026Article
- Quality of life and anorectal function in rectal cancer patients undergoing immunotherapy-based total neoadjuvant therapy: a comparison of organ preservation and radical surgery.Clinical and translational radiation oncology · 2026Article
- Organ preservation in rectal cancer following clinical complete response after short-course radiotherapy-based total neoadjuvant therapy.Clinical and translational radiation oncology · 2026Article
- Report from the 27th Annual Western Canadian Gastrointestinal Cancer Consensus Conference on Colorectal Cancer, Calgary, Alberta, 26-27 September 2025: Advances in Colon and Rectal Cancer.Current oncology (Toronto, Ont.) · 2026Article
- Total Neoadjuvant Therapy with FOLFOX Followed by Short-Course Radiation in Locally Advanced Rectal Cancer-An Alternative Approach Evaluated in a Single-Center Clinical Trial.Journal of clinical medicine · 2026Article
- Article
- Article
- Watch and wait in locally advanced rectal cancer: Evolution, current evidence, and future directions.World journal of gastrointestinal surgery · 2025Review
- The role of radiotherapy in the management of metastatic rectal cancer: A narrative review on the opportunities for non-operative management and organ preservation.Clinical and translational radiation oncology · 2025Review
- Lessons from FOWARC: moving towards the more precise use of radiation therapy in the era of total neoadjuvant therapy.AME clinical trials review · 2025Article
- No operation after short-course radiotherapy followed by consolidation chemotherapy in locally advanced rectal cancer (NOAHS-ARC): study protocol for a prospective, phase II trial.International journal of colorectal disease · 2025Article
- Mastering rectal cancer MRI: From foundational concepts to optimal staging.European journal of radiology · 2025Review
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Authors and funding
39 authors.
Funding
Abstract
backgroundPotential differences in organ preservation between total neoadjuvant therapy (TNT) regimens integrating long-course chemoradiotherapy (LCCRT) and short-course radiotherapy (SCRT) in rectal cancer remain undefined. PATIENTS AND
methodsThis natural experiment arose from a policy change in response to the COVID-19 pandemic during which our institution switched from uniformly treating patients with LCCRT to mandating that all patients be treated with SCRT. Our study includes 323 locally advanced rectal adenocarcinoma patients treated with LCCRT-based or SCRT-based TNT from January 2018 to January 2021. Patients who achieved clinical complete response were offered organ preservation with watch-and-wait (WW) management. The primary outcome was 2-year organ preservation. Additional outcomes included local regrowth, distant recurrence, disease-free survival (DFS), and overall survival (OS).
resultsPatient and tumor characteristics were similar between LCCRT (n = 247) and SCRT (n = 76) cohorts. Median follow-up was 31 months. Similar clinical complete response rates were observed following LCCRT and SCRT (44.5% versus 43.4%). Two-year organ preservation was 40% [95% confidence interval (CI) 34% to 46%] and 31% (95% CI 22% to 44%) among all patients treated with LCCRT and SCRT, respectively. In patients managed with WW, LCCRT resulted in higher 2-year organ preservation (89% LCCRT, 95% CI 83% to 95% versus 70% SCRT, 95% CI 55% to 90%; P = 0.005) and lower 2-year local regrowth (19% LCCRT, 95% CI 11% to 26% versus 36% SCRT, 95% CI 16% to 52%; P = 0.072) compared with SCRT. The 2-year distant recurrence (10% versus 6%), DFS (90% versus 90%), and OS (99% versus 100%) were similar between WW patients treated with LCCRT and SCRT, respectively.
conclusionsWhile WW eligibility was similar between cohorts, WW patients treated with LCCRT had higher 2-year organ preservation and lower local regrowth than those treated with SCRT, yet similar DFS and OS. These data support induction LCCRT followed by consolidation chemotherapy as the preferred TNT regimen for patients with locally advanced rectal cancer pursuing organ preservation.
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