In what situations can short course RT (5 Gy x 5fx) be used instead of chemoRT for rectal cancer?
Answer from: Radiation Oncologist at Academic Institution
My take? Preop short course RT is grossly underutilized in the US for locally advanced rectal cancer.Progress is slow but we are getting there; the 2019 version of the NCCN guidelines lists SCRT followed by resection as a standard option for patients w/ T3 or N+ disease as long as the CRM is clear b...
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Radiation Oncologist at Minneapolis Radiation Oncology @Robert J. Myerson, are there any published data o...
Radiation Oncologist at Washington University School of Medicine I can find published recommendations but no publis...
Radiation Oncologist at Minneapolis Radiation Oncology Thanks very much.
Answer from: Radiation Oncologist at Academic Institution
Every locally advanced rectal cancer patient is a candidate for short course radiation, especially short course radiation therapy followed by systemic chemotherapy as part of a 'total neoadjuvant therapy' approach.For the patient, this SC-TNT treatment means:-> less visits for radiation therapy-&...
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Radiation Oncologist at Varian Medical Systems/Allegheny health network What about recent data showing in patients with pe...
Radiation Oncologist at Henry Ford Health System @Sushil Beriwal, this is an excellent discussion p...
Answer from: Radiation Oncologist at Academic Institution
I think it's reasonable to use in any rectal cancer where you are not concerned about a possible positive margin. The MRC CR07 trial clearly showed that patients in any location of tumor (lower, mid, upper) derived some benefit in local control from short course radiation when compared to selective...
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Radiation Oncologist at Brigham and Women's Hospital I agree completely with @Theodore S. Hong's commen...
Answer from: Radiation Oncologist at Academic Institution
The answers to this question might well be changed in one to two years, when outcome data from the PROSPECT and RAPIDO trials are released. There are some "what ifs" to keep in mind.
The PROSPECT and RAPIDO trials both compare standard preoperative long course CRT with a regimen that reduces the ti...
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Radiation Oncologist at Cancer Specialists of North Florida Thank you for the excellent breakdown of the two t...
Answer from: Radiation Oncologist at Community Practice
I think the indication is evolving with ongoing studies trying to integrate neoadjuvant chemo with this hypofractionation regimen.
At present, we sometimes use it for elderly patients with upper rectal cancers only.
@Robert J. Myerson, are there any published data o...
I can find published recommendations but no publis...
Thanks very much.