Abstract
Purpose
Two treatment modalities are considerable for radiation therapy: short-course radiotherapy and immediate surgery or chemoradiation with 5-Fluorouracil based chemotherapy with delayed surgery. In this study, we try to evaluate the real-life treatment approaches of medical, radiation, and surgical oncologists for neoadjuvant treatment of rectal cancers.
Method
The online survey form was established via Google Forms. The survey was taken voluntarily by medical oncologists, radiation oncologists, surgical oncologists, and general surgeons.
Results
One hundred eighty-three of the participants were medical oncologists while 36 were radiotherapists and 36 were surgeons. Most of the study population preferred long-course radiation therapy and chemotherapy which was consisting eighty-five percent. Two-thirds of the participants apply chemotherapies before operation. The most frequent chemotherapy cycles for the pre-operative setting were ‘three’ or ‘four-or-more’ with the percent of 27,8 and 25,1 respectively. Medical oncologists had a significantly higher tendency of offering chemotherapy between radiation therapy and surgery compared with the other groups. The optimal time of surgery was different between groups. There was no difference among groups between surgery and the ‘watch & wait’ strategy. A significant difference was observed between groups in offered neoadjuvant chemotherapy regimens.
Conclusion
In our study, we found the new pre-operative chemotherapy regimen with short-course radiotherapy was slowly adopted in current practice. Also, medical oncologists tend pre-operative chemotherapy compared with other groups. The optimal surgery time for patients receiving neoadjuvant treatment is still controversial.
Sequential short-course radiation therapy and chemotherapy in the neoadjuvant treatment of rectal adenocarcinoma
