Long course neoadjuvant chemoRT for rectal cancer

Sauer et. al., NEJM 2004 - Pre-op vs Post-op ChemoRT for Rectal ca
- no difference in overall survival but improved local recurrence rate
in pts with long course therapy.

Protocol:
- Radiation 5d per week for five weeks
- continuous 5-FU infusion during weeks 1 and 5.
- surgery performed within 6 weeks of completion of therapy
- decreases local recurrence from 13% to 6% in T3, T4 or N1 disease compared to postoperative adjuvant therapy.
- there was also a decrease in treatment toxicity (40% vs 27%) compared to postoperative adjuvant therapy.
- But no difference in overall survival.