Short-course versus long-course neoadjuvant radiotherapy for lower rectal cancer: a systematic review.

OBJECTIVE To analyse the efficacy of short-course (SCRT) versus long-course radiotherapy/chemoradiation (LCRT) as a neoadjuvant modality for the management of lower rectal cancer (LRC). METHODS A systematic review of the literature was undertaken. Selected trials were analysed to generate a summative outcome. RESULTS Seven trials on the efficacy of SCRT versus LCRT as a neoadjuvant modality for LRC encompassing 1,675 patients were retrieved but only 2 randomized trials on 396 patients qualified for this review. In both the fixed and random effects models, LCRT and SCRT were associated with equal overall survival, tumour recurrence, perioperative complications, sphincter preservation rate and toxicity. CONCLUSIONS SCRT and LCRT may be as effective as traditional LCRT in terms of overall survival, recurrence, perioperative complications, sphincter preservation and toxicity. Traditional neoadjuvant chemoradiation may continue to be used.