When treating patients with rectal cancer, radiation oncologists in the US are less likely to offer neoadjuvant short-course radiotherapy (SC-RT) over long-course chemoradiotherapy (LC-CRT) despite the therapies having similar outcomes, according to a study published in Cancer.1

Researchers evaluated survey responses from 182 radiation oncologists who were asked the volume of patients with rectal cancer they had treated, whether they preferred SC-RT or LC-CRT, and what factors they considered when choosing 1 regimen over the other.

Eighty-three percent of responding physicians treated at least 5 patients with rectal cancer every year, with 96% of them preferring to treat these patients with neoadjuvant LC-CRT and 44% having never used SC-RT.

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Physicians listed “insufficient downstaging for sphincter preservation” and a “desire for longer follow-up” as the most common reasons for not offering SC-RT.

Among physicians who had offered SC-RT, they stated that they would not choose the regimen for patients who had low or bulky tumors, or those with a “positive circumferential surgical resection margin.” Seventy-nine percent of responding physicians said comorbidities influenced their preference for regimen choice.

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“Further research is necessary to determine whether longer follow-up coupled with the benefits of lower cost, increased patient convenience, and lower acute toxicity will increase adoption of SC-RT by radiation oncologists in the US,” the authors concluded.


  1. Mowery YN, Salama JK, Zafar SY, et al. Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States. Cancer. 2016 Dec 16. doi: 10.1002/cncr.30461 [Epub ahead of print]