Chemoradiotherapy for Rectal Cancer: An Updated Analysis of Factors Affecting Pathological Response

Clinical Oncology

Volumn 20, Issue 2, 2008, Pages 176-183

  Sanghera, P ^a   Wong, D W Y ^a   McConkey, C C ^b   Geh, J I ^a   Hartley, A ^a  

^a QUEEN ELIZABETH HOSPITAL   (United Kingdom)

^b UNIVERSITY OF WARWICK   (United Kingdom)

Author keywords

Chemoradiotherapy; chemotherapy; pathological complete response; radiotherapy; rectal cancer

Indexed keywords

ANTINEOPLASTIC AGENT; CAPECITABINE; CISPLATIN; FLUOROPYRIMIDINE; FLUOROURACIL; IRINOTECAN; METHOTREXATE; MITOMYCIN; MITOMYCIN C; OXALIPLATIN; RALTITREXED; TAXANE DERIVATIVE;

ADJUVANT CHEMOTHERAPY; ARTICLE; CANCER CONTROL; CANCER RADIOTHERAPY; CLINICAL TRIAL; CONTINUOUS INFUSION; EMBASE; FACTORIAL ANALYSIS; HUMAN; MEDLINE; MULTIVARIATE ANALYSIS; PEER REVIEW; PREOPERATIVE TREATMENT; PRIORITY JOURNAL; PUBLICATION; RADIATION DOSE; RECTUM CANCER; STATISTICAL SIGNIFICANCE; TREATMENT RESPONSE;

ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; CHEMOTHERAPY, ADJUVANT; CLINICAL TRIALS, PHASE II AS TOPIC; CLINICAL TRIALS, PHASE III AS TOPIC; COMBINED MODALITY THERAPY; DATABASES, BIBLIOGRAPHIC; DOSE-RESPONSE RELATIONSHIP, RADIATION; FLUOROURACIL; HUMANS; MULTIVARIATE ANALYSIS; NEOADJUVANT THERAPY; RADIOTHERAPY, ADJUVANT; RECTAL NEOPLASMS; TREATMENT OUTCOME;

EID: 39049169018     PISSN: 09366555     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.clon.2007.11.013     Document Type: Article

References (95)

1. Heald R.J., and Ryall R.G. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1 (1986) 1479-1482
2. Colorectal Cancer Collaborative Group. Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials. Lancet 358 (2001) 1291-1304
3. Gerard J.P., Conroy T., Bonnetain F., et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol 24 (2006) 4620-4625
4. Bosset J.F., Collete L., Calaise G., et al. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 355 (2006) 1114-1123
5. Sauer R., Heinz B., Werner H., et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351 (2004) 1731-1740
6. Adam I.J., Mohamdee M.O., and Martin I.G. Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet 344 (1994) 707-711
7. MERCURY Study Group. Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. Br Med J 333 (2006) 779-782
8. Kapiteijn E., Kranenbarg E.K., Steup W.H., et al. Total mesorectal excision (TME) with or without preoperative radiotherapy in the treatment of primary rectal cancer. Prospective randomised trial with standard operative and histopathological techniques. Dutch Colorectal Cancer Group. Eur J Surg 165 (1999) 410-420
9. Sebag-Montefiore D, Steele R, Quirke P, et al. Routine short course pre-op radiotherapy or selective post-op chemoradiotherapy for resectable rectal cancer? Preliminary results of the MRC CR07 randomised trial. In: Proceedings of ASCO 2006 [3511].
10. Marijnen C.A., Nagtegaal I.D., Kapiteijn E., et al. Radiotherapy does not compensate for positive resection margins in rectal cancer patients: report of a multicenter randomized trial. Int J Radiat Oncol Biol Phys 55 (2003) 1311-1320
11. Alberti A, Tomei F, Miele E, et al. Concurrent radiotherapy (RT) and chemotherapy (CT) with oxaliplatin as primary treatment of advanced rectal cancer: a phase II study. In: Proceedings of ASCO 2006 [A13507].
12. Alonso V, Salud A, Escudero P, et al. Phase II trial of preoperative chemoradiotherapy with irinotecan and infusional 5-fluorouracil in locally advanced operable rectal carcinoma. In: Proceedings of ASCO 2005 [A3542].
13. Aschele C., Friso M.L., Pucciarelli S., and Lonardi S. A phase I-II study of weekly oxaliplatin, 5-fluorouracil continuous infusion and preoperative radiotherapy in locally advanced rectal cancer. Ann Oncol 16 (2005) 1140-1146
14. Avallone A., Delrio P., Guida C., et al. Biweekly oxaliplatin, raltitrexed, 5-fluorouracil and folinic acid combination chemotherapy during preoperative radiation therapy for locally advanced rectal cancer: a phase I-II study. Br J Cancer 94 (2006) 1809-1815
15. Bhagarva P, Smyczynzki M, Swanson W, et al. Preoperative chemoradiotherapy with weekly paclitaxel for localised rectal cancer. In: Proceedings of ASCO 2003 [A1485].
16. Bosset J., Magnin V., Maingon M., et al. Preoperative radiochemotherapy in rectal cancer: long term results of a phase II trial. Int J Radiat Oncol Biol Phys 46 (2000) 323-327
17. Bosset J.F., Calais G., Mineur L., et al. Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: preliminary results-EORTC 22921. J Clin Oncol 23 (2005) 5620-5627
18. Boulis-Wassif S., Gerard A., Loygue J., Camelot D., Buyse M., and Duez N. Final results of a randomised trial on the treatment of rectal cancer with preoperative radiotherapy alone or in combination with 5-fluorouracil followed by radical surgery. Cancer 53 (1984) 1811-1818
19. Bujko K., Nowacki M., Naiserowska-Guttmejer A., et al. Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy. Radiother Oncol 72 (2004) 15-24
20. Carau B., Orru P., Orru S., et al. Neoadjuvant radiochemotherapy treatment in locally advanced rectal adenocarcinoma. Tumori 89 (2003) 7-8
21. Carraro S., Roca E., Cartelli C., et al. Radiochemotherapy with short daily infusion of low dose oxaliplatin, leucovorin and 5FU in T3-T4 unresectable rectal cancer: a phase II IATTGI study. Int J Radiat Oncol Biol Phys 54 (2002) 397-402
22. Carraro S, Roca E, Milano C, et al. Rectal cancer: preoperative radiochemotherapy with 5-FU, leucovorin and cisplatin. A three year follow up analysis. In: Proceedings of ASCO 1999 [A1073].
23. Chan A., Wong A., Langevin J., et al. Preoperative chemotherapy and pelvic radiation for tethered or fixed rectal cancer: a phase II dose escalation study. Int J Radiat Oncol Biol Phys 48 (2000) 843-856
24. Chan A., Wong A., Jenken D., Heine J., Buie D., and Johnson D. Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys 61 (2005) 665-677
25. Chang H., Jian J., Cheng S., et al. Preoperative concurrent chemotherapy and radiotherapy in rectal cancer patients. J Formos Med Assoc 97 (1998) 32-37
26. Chari R., Tyler D., Anscher M., et al. Preoperative radiation and chemotherapy in the treatment of adenocarcinoma of the rectum. Ann Surg 221 (1995) 778-787
27. Chau I., Allen M., Cunningham D., et al. Neoadjuvant systemic flurouracil and mitomycin C prior to synchronous chemoradiation is an effective strategy in locally advanced rectal cancer. Br J Cancer 88 (2003) 1017-1024
28. Chau I., Brown G., Cunningham D., et al. Neoadjuvant capecitabine and oxaliplatin followed by synchronous chemoradiation and total mesorectal excision in magnetic resonance imaging-defined poor-risk rectal cancer. J Clin Oncol 24 (2006) 668-674
29. Chen E., Mohiuddin M., Brodowsky H., Fishbein G., and Marks G. Downstaging of advanced rectal cancer following combined preoperative chemotherapy and high dose radiation. Int J Radiat Oncol Biol Phys 30 (1994) 169-175
30. Ciabatoni A., Cavallaro A., Potenza A., et al. Preoperative concomitant radiochemotherapy with a 5-flurouracil plus folinic acid bolus in the combined treatment of locally advanced extraperitoneal rectal cancer: a long-term analysis on 27 patients. Tumori 89 (2003) 157-163
31. Conzo G., Caraco C., Vacca R., et al. Neoadjuvant chemoradiotherapy in the treatment of rectal cancer: preliminary results. G Chir 21 (2000) 319-322
32. Cordio S, Vitali G, Ronzoni M, et al. Preoperative hyperfractionated radiotherapy (HFRT) and concomitant chemotherapy (CT) in locally advanced primary rectal cancer (LA-PRC) in elderly patients. In: Proceedings of ASCO 2005 [A3661].
33. De la Torre A., Ramos S., Valcarcel F., et al. Phase II study of radiochemotherapy with UFT and low-dose oral leucovorin in patients with unresectable rectal cancer. Int J Radiat Oncol Biol Phys 45 (1999) 629-634
34. Feliu J., Calvilio J., Escribano A., et al. Neoadjuvant therapy of rectal carcinoma with UFT-leucovorin plus radiotherapy. Ann Oncol 13 (2002) 730-736
35. Fernandez-Martos C., Aparicio J., Bosch C., et al. Preoperative uracil, tegafur, and concomitant radiotherapy in operable rectal cancer: a phase II multicenter study with 3 years' follow-up. J Clin Oncol 22 (2004) 3016-3022
36. Fernandez-Martos C, Bosch C, Aparicio J, et al. Oxaliplatin (OXA), uracil/tegafur (UFT) and radiotherapy (RT) in operable rectal cancer (RC). Preliminary results of a multicenter phase II study. In: Proceedings of ASCO 2005 [A3648].
37. Frykholm G., Pahlman L., and Glimelius B. Combined chemo- and radiotherapy vs. radiotherapy alone in the treatment of primary, nonresectable adenocarcinoma of the rectum. Int J Radiat Oncol Biol Phys 50 (2001) 427-434
38. Galizia E, Antognoli S, Bracci R, et al. Preoperative chemotherapy plus concomitant radiotherapy in rectal cancer patients: a phase II study. In: Proceedings of ASCO 2002 [A2374].
39. Gambacorta M.A., Valentini V., Morganti A.G., and Mantini G. Chemoradiation with raltitrexed (Tomudex) in preoperative treatment of stage II-III resectable rectal cancer: a phase II study. Int J Radiat Oncol Biol Phys 60 (2004) 130-138
40. Gemici C, Mayadagli A, Salepci T, Yaprak G, Seseogullari OO, Tugrul F. Preoperative radiation in combination with uracil/tegafur (UFT) and mitomycin C (MMC) in locally advanced rectal adenocarinoma. In: Proceedings of ASCO 2006 [A13512].
41. Gerard J., Chapet O., Nemoz C., et al. Preoperative concurrent chemoradiotherapy in locally advanced rectal cancer with high-dose radiation and oxaliplatin-containing regimen: the Lyon R0-04 phase II trial. J Clin Oncol 21 (2003) 1119-1124
42. Grann A., Feng C., Wong D., et al. Preoperative combined modality therapy for clinically resectable uT3 rectal adenocarcinoma. Int J Radiat Oncol Biol Phys 49 (2001) 987-995
43. Kim J.C., Kim T.W., Kim J.H., et al. Preoperative concurrent radiotherapy with capecitabine before total mesorectal excision in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 63 (2005) 346-353
44. Kim J., Kim J., Cho M., Song K., and Yoon W. Preoperative chemoradiation using oral capecitabine in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 54 (2002) 402-408
45. Kim N., Min J., Park J., et al. Intravenous 5-fluorouracil versus oral doxifluridine as preoperative concurrent chemoradiation for locally advanced rectal cancer: prospective randomised trials. Jpn J Clin Oncol (2001) 25-29
46. Klautke G., Küchenmeister U., Foitzik T., et al. Concurrent chemoradiation with capecitabine and weekly irinotecan as preoperative treatment for rectal cancer: results from a phase I/II study. Br J Cancer 94 (2006) 976-981
47. Klautke G., Feyerherd P., Ludwig K., Prall F., Foitzik T., and Fietkau R. Intensified concurrent chemoradiotherapy with 5-fluorouracil and irinotecan as neoadjuvant treatment in patients with locally advanced rectal cancer. Br J Cancer 92 (2005) 1215-1220
48. Kocakova I, Svoboda M, Klocova K, et al. Combined therapy of locally advanced rectal adenocarcinoma with capecitabine and concurrent radiotherapy. In: Proceedings of ASCO 2004 [3720].
49. Lin EH, Skibber J, Delcos M, et al. A phase II study of capecitabine and concomitant boost radiotherapy (XRT) in patients (pts) with locally advanced rectal cancer (LARC). In: Proceedings of ASCO 2005 [A3593].
50. Machiels J, Duck L, Honhon B, et al. Phase II study of preoperative oxaliplatin, capecitabine, and external beam radiotherapy in patients with locally advanced rectal adenocarcinoma: the RadiOxCape Study. In: Proceedings of ASCO Gastrointestinal Symposium 2005 [A245].
51. Mermershtain W, Walfisch S, Koretz M, Geffen D, Cohen Y. Preoperative radiochemotherapy treatment in advanced rectal carcinoma. In: Proceedings of ASCO 1998 [A1144].
52. Mehta V., Poen J., Ford J., et al. Radiotherapy, concomitant protracted-venous-infusion 5-fluorouracil and surgery for ultrasound-staged T3 or T4 rectal cancer. Dis Colon Rectum 44 (2001) 52-58
53. Mehta V., Cho C., Ford J., et al. Phase II trial of preoperative 3D conformal radiotherapy, protracted venous infusion 5-fluorouracil, and weekly CPT-11 followed by surgery for ultrasound-staged T3 rectal cancer. Int J Radiat Oncol Biol Phys 55 (2003) 132-137
54. Mohiuddin M., Regine W., John W., et al. Preoperative chemoradiation in fixed distal rectal cancer: dose time factors for pathological complete response. Int J Radiat Oncol Biol Phys 46 (2000) 883-888
55. Mohiuddin M., Winter K., Mitchell E., et al. Randomized phase II study of neoadjuvant combined-modality chemoradiation for distal rectal cancer: Radiation Therapy Oncology Group Trial 0012. J Clin Oncol 24 (2006) 650-655
56. Navarro M., Dotor E., Rivera F., et al. A phase II study of preoperative radiotherapy and concomitant weekly irinotecan in combination with protracted venous infusion 5-fluorouracil, for resectable locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 66 (2006) 201-205
57. Ngan S., Burmeister B., Fisher R., et al. Early toxicity from preoperative radiotherapy with continuous infusion 5-fluorouracil for resectable adenocarcinoma of the rectum: a phase II trial for the Trans-Tasman Radiation Oncology Group. Int J Radiat Oncol Biol Phys 50 (2001) 883-887
58. Porter H, Anwar S, Grieve R, et al. Concurrent raltitrexed and radiotherapy for locally advanced rectal carcinoma. In: Proceedings of ASCO 2003 [A1390].
59. Privitera G, Spatola C, Acquaviva G, et al. Neoadjuvant XELOX vs. XELIRI in combination with concomitant boost 3D-conformal radiotherapy in locally advanced rectal cancer (LARC). In: Proceedings of ASCO 2006 [A3570].
60. Roh M, Petrelli N, Wieand S, et al. Phase III randomised trial of preoperative versus postoperative multimodality therapy in patients with carcinoma of the rectum (NSABP R-03). In: Proceedings of ASCO 2001 [A490].
61. Ronzoni M, Cozzarini C, Villa E, San Raffaele H. Tumour downstaging and sphincter preservation with preoperative hyperfractionated radiation therapy and concurrent chemotherapy in locally advanced rectal cancer. In: Proceedings of ASCO 2002 [A2299].
62. Ryan D.P., Niedzwiecki D., Hollis D., et al. Phase I/II study of preoperative oxaliplatin, fluorouracil, and external-beam radiation therapy in patients with locally advanced rectal cancer: Cancer and Leukemia Group B 89901. J Clin Oncol 24 (2006) 2557-2562
63. Salimichokami M, Vafai M, Derakhshani S, Aminian S, Vaheed A. A phase-2 study of neoadjuvant chemoradiation in locally advanced rectal adenocarcinoma: the Radio-Xelox study. In: Proceedings of ASCO 2006 [A13549].
64. Salud A, Alonso V, Lambea J, et al. Preoperative chemoradiotherapy with capecitabine and oxaliplatin in locally advanced rectal carcinoma: preliminary results. In: Proceedings of ASCO 2006 [A13543].
65. Schefter TE, Ballonoff A, McCarter M, et al. Phase II trial of preoperative capecitabine and accelerated intensity modulated radiotherapy in locally advanced rectal cancer. In: Proceedings of ASCO Gastrointestinal Symposium 2007 [A395].
66. Sebag-Montefiore D., Glynne-Jones R., Falk S., Meadows H.M., and Maughan T. A phase I/II study of oxaliplatin when added to 5-fluorouracil and leucovorin and pelvic radiation in locally advanced rectal cancer: a Colorectal Clinical Oncology Group (CCOG) study. Br J Cancer 93 (2005) 993-998
67. Seong J., Cho J., Kim N., Min J., and Suh C. Preoperative chemoradiotherapy with oral doxifluridine plus low-dose oral leucovorin in unresectable primary rectal cancer. Int J Radiat Oncol Biol Phys 50 (2001) 435-439
68. Tamberi S, Luppi G, Perrone AE, et al. Preoperative 5-fluorouracil (5-FU) in continuous infusion concurrent to radiotherapy and sphincter preservation in distal rectal adenocarcinoma: results of a multicentre study. In: Proceedings of ASCO 2001 [A2239].
69. Tjandra J., Reading D., McLachlan S., et al. Phase II clinical trial of preoperative combined chemoradiation for T3 and T4 resectable rectal cancer. Dis Colon Rectum 44 (2001) 113-122
70. Turitto G., Panelli G., Frattolillo A., et al. Phase II study of neoadjuvant concurrent chemoradiotherapy with oxaliplatin-containing regimen in locally advanced rectal cancer. Front Biosci 11 (2006) 1275-1279
71. Uzcudun A., Batlle J., Velasco J., et al. Efficacy of preoperative radiation therapy for resectable rectal adenocarcinoma when combined with oral tegafur-uracil modulated with leucovorin. Dis Colon Rectum 45 (2002) 1349-1358
72. Valentini V., Coco C., Cellini N., et al. Ten years of preoperative chemoradiation for extraperitoneal T3 rectal cancer: acute toxicity, tumor response, and sphincter preservation in three consecutive studies. Int J Radiat Oncol Biol Phys 51 (2001) 371-383
73. Velenik V., Anderluh F., Oblak I., Strojan P., and Zakotnik B. Capecitabine as a radiosensitizing agent in neoadjuvant treatment of locally advanced resectable rectal cancer: prospective phase II trial. Croat Med J 47 (2006) 693-700
74. Vicario G, Santori C, Manente P, et al. A phase II study of neoadjuvant chemoradiotherapy in patients with adenocarcinoma of the rectum. In: Proceedings of ASCO 2002 [A2363].
75. Wang L.W., Yang S.H., Lin J.K., et al. Pre-operative chemoradiotherapy with oral tegafur-uracil and leucovorin for rectal cancer. J Surg Oncol 89 (2005) 256-263
76. Willeke F, Tiefenbacher U, Hochhaus A, et al. Phase II trial of capecitabine and irinotecan in combination with concurrent radiotherapy for neoadjuvant treatment of locally advanced rectal cancer. In: Proceedings of ASCO 2005 [A3589].
77. Wiltshire K, Brierley J, Swallow C, et al. Preoperative radiation with concurrent chemotherapy for resectable rectal cancer: effect of dose escalation on pathological complete response and wound complication rates. In: Proceedings of ASCO Gastrointestinal Symposium 2004 [A291].
78. Wong S, Sadasiwan C, Erickson B, et al. A phase II trial of preoperative capecitabine and concurrent radiation for locally advanced rectal cancer. In: Proceedings of ASCO Gastrointestinal Symposium 2004 [A281].
79. Yoon W, Choi J, Kin J, et al. Enhanced tumoricidal effect of preoperative chemoradiation using capecitabine for locally advanced rectal cancer. In: Proceedings of ASCO 2001 [A2165].
80. Hartley A., Ho K.F., McConkey C., and Geh J.I. Pathological complete response following pre-operative chemoradiotherapy in rectal cancer: analysis of phase II/III trials. Br J Radiol 78 (2005) 934-938
81. Glynne-Jones R., and Anyamene N. Just how useful an endpoint is complete pathological response after neoadjuvant chemoradiation in rectal cancer?. Int J Radiat Oncol Biol Phys 66 (2006) 319-320
82. Rodel C., Martus P., Papadoupolos T., et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. J Clin Oncol 23 (2005) 8688-8696
83. Saltz L.B., Cox J.V., Blanke C., et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 343 (2000) 905-914
84. De Gramont A., Figer A., Seymore M., et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18 (2000) 2938-2947
85. Aschele C, Pinto C, Cordio S, et al. Preoperative FU-based chemoradiation with or without weekly oxaliplatin in locally advanced rectal cancer: preliminary safety findings of the STAR (Studio Terapia Adiuvante Retto)-01 randomized trial. In: Proceedings of ASCO Gastrointestinal Symposium 2007 [A4040].
86. Byfield J.E., Calbro-Jones P., Klisak I., et al. Pharmacologic requirements for obtaining sensitization of human tumor cells in vitro to combined 5-fluorouracil or ftorafur and X rays. Int J Radiat Oncol Biol Phys 8 (1982) 1923-1933
87. O'Connell M.J., Martenson J.A., Wieand J.S., et al. Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 331 (1994) 502-507
88. Smalley S.R., Benedetti J.K., Williamson S.K., et al. Phase III trial of fluorouracil-based chemotherapy regimens plus radiotherapy in postoperative adjuvant rectal cancer: GI INT 0144. J Clin Oncol 24 (2006) 3542-3547
89. Sawada N., Ishikawa T., Sekiguchi F., et al. X-ray irradiation induces thymidine phosphorylase and enhances the efficacy of capecitabine (Xeloda) in human cancer xenografts. Clin Cancer Res 5 (1999) 2948-2953
90. Kim D.Y., Jung K.H., Kim T.H., et al. Comparison of 5-fluorouracil/leucovorin and capecitabine in preoperative chemoradiotherapy for locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 67 (2007) 378-384
91. Geh J.I., Bond S.J., Bentzen S.M., and Glynne-Jones R. Systematic overview of preoperative (neoadjuvant) chemoradiotherapy trials in oesophageal cancer: evidence of a radiation and chemotherapy dose response. Radiother Oncol 78 (2006) 236-244
92. Gerard J.P., Chapet O., Nemoz C., et al. Improved sphincter preservation in low rectal cancer with high-dose preoperative radiotherapy: the Lyon R96-02 randomized trial. J Clin Oncol 22 (2004) 2404-2409
93. Gerard J.P., Chapet O., Ramaioli A., and Romestaing P. Long-term control of T2-T3 rectal adenocarcinoma with radiotherapy alone. Int J Radiat Oncol Biol Phys 54 (2002) 142-149
94. O'Neill B.D., Brown G., Heald R.J., Cunningham D., and Tait D.M. Non-operative treatment after neoadjuvant chemoradiotherapy for rectal cancer. Lancet Oncol 8 (2007) 625-633
95. UK Co-ordinating Committee on Cancer. Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. Research. Lancet 348 (1996) 1049-1054