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...

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-&...

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...

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...

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.

We have used it for recurrent disease reirradiation with SBRT using Cyberknife-6Gyx5 on alternate days. Colostomy is must.