Should we be shrinking rectal cancer fields?
With trials like PROSPECT and FOWARC showing no statistically significant improvement in locoregional control and survival outcomes when comparing radiation-containing neoadjuvant treatment to chemotherapy alone, are we moving towards the elimination of elective nodal irradiation in the pelvis?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of Rochester School of Medicine and Dentistry
Answered on
I think this is a good point. However, I think we need to consider the nuances of the question. First PROSPECT included: patients that "had cT2N+, cT3N-, cT3N+ rectal cancers deemed appropriate for neoadjuvant therapy prior to low anterior resection with TME. Patients with distal, T4 tumors, threate...
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Mednet Member
Radiation Oncology · Sunnybrook Health Sciences Centre
Answered on · Updated on
Definitely agree with all the points made above for and against shrinking fields.
I believe it's appropriate to think about shrinking fields especially with publications of OPERA results (Gerard et al., PMID 36801007), that with the addition of brachytherapy, one can achieve a significantly higher c...
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