EORTC-22921

Regimen

Experimental
Preoperative RT ± concurrent 5-FU/LV → surgery → ± adjuvant 5-FU/LV (2×2 factorial)
Control
Multiple arms in 2×2 factorial design: ±preop chemotherapy, ±adjuvant chemotherapy

Population

Clinical T3–T4 resectable rectal cancer (N=1,011); 2×2 factorial evaluating role of preoperative and adjuvant chemotherapy with radiotherapy.

Key finding

At 10-year follow-up: adjuvant chemo vs surveillance: OS HR 0.91 (P=0.32, not significant); DFS also not significantly different. Local control improved with preoperative CRT vs RT alone (11.8% vs 22.4% LR at 10 years). Adjuvant chemotherapy after preoperative CRT does NOT improve OS or DFS.

Source: PMID 24440473

Timeline

    Guideline citations

    • NCCN Colon (p.58)
    • NCCN Rectal (p.57)