Acute and Late Radiation-Related Toxicity After Treatment of Locally Advanced Rectal Cancer With Intensity Modulated Radiation Therapy Compared With 3-Dimensional Conformal Radiation Therapy in the RAPIDO Trial.

Purpose: Intensity modulated radiation therapy (IMRT) aims to lower radiation-related toxicity by delivering more conformal radiation therapy compared with 3-dimensional conformal radiation therapy (3D-CRT). This study investigated whether IMRT (including volumetric modulated arc therapy) resulted in less acute and late radiation-related toxicity and better treatment compliance compared with 3D-CRT in the phase 3 RAPIDO trial.

Methods And Materials: Patients with locally advanced rectal cancer (LARC), treated with short-course radiation therapy followed by consolidation therapy (total neoadjuvant treatment [TNT] arm) or chemoradiation therapy with optional postoperative chemotherapy (CRT arm) were included.

Validated Pretreatment Prediction Models for Response to Neoadjuvant Therapy in Patients with Rectal Cancer: A Systematic Review and Critical Appraisal.

Pretreatment response prediction is crucial to select those patients with rectal cancer who will benefit from organ preservation strategies following (intensified) neoadjuvant therapy and to avoid unnecessary toxicity in those who will not. The combination of individual predictors in multivariable prediction models might improve predictive accuracy. The aim of this systematic review was to summarize and critically appraise validated pretreatment prediction models (other than radiomics-based models or image-based deep learning models) for response to neoadjuvant therapy in patients with rectal cancer and provide evidence-based recommendations for future research.

Towards Response ADAptive Radiotherapy for organ preservation for intermediate-risk rectal cancer (preRADAR): protocol of a phase I dose-escalation trial.

Introduction: Organ preservation is associated with superior functional outcome and quality of life (QoL) compared with total mesorectal excision (TME) for rectal cancer. Only 10% of patients are eligible for organ preservation following short-course radiotherapy (SCRT, 25 Gy in five fractions) and a prolonged interval (4-8 weeks) to response evaluation. The organ preservation rate could potentially be increased by dose-escalated radiotherapy.