Radiotherapy before surgery slashes bowel cancer recurrence says trial
An international clinical trial has found a way to minimise the risk of tumour recurrence in bowel cancer patients to as little as one per cent. The Medical Research Council (MRC) trial looked at data from 1,350 patients throughout the UK, Canada, South Africa and New Zealand.
Traditionally, surgical removal of cancer found in the lower 15 centimetres of the bowel (rectum) has been the treatment of choice.
However, simply removing the tumour leaves a risk of re-growth within the bowel and surrounding tissues. Not only is this recurrence difficult to treat, but it can cause distressing symptoms that are difficult to control.
The trial looked at the use of radiotherapy before surgery (pre-operative) compared with radiotherapy after surgery (post-operative).
In the first group, patients were given five daily treatments of radiotherapy followed by surgical removal of the tumour within two weeks.
In the second group, patients had their tumour removed first, and then, if necessary, received twenty five treatments of radiotherapy over a five-week period combined with chemotherapy.
Comparison of these treatments found that only five per cent of patients in the pre-operative group had local recurrence of the cancer after five years, compared with 17 per cent of the post-operative group.
It also found that pre-operative patients had a higher chance (75 per cent) of being alive five years later that the post-operation patients (67 per cent).
"There are approximately 35,000 cases of bowel cancer diagnosed every year in the UK alone," said principal investigator Dr David Sebag-Montefiore.
"The results of this trial show that giving a patient radiotherapy before rectal cancer surgery gives them the best chance of avoiding re-growth of the cancer and of survival in the longer term.
"This is good news for patients and clinicians alike and could lead to an increase in the use of pre-operative radiotherapy in the UK."
The study was presented at the NCRI Cancer Conference in Birmingham.