![]() ![]() RT target volumes did not differ between the EXP and STD groups. According to hospital policy, patients in the STD group could receive postoperative 8 cycles of CAPOX or 12 cycles of FOLFOX4. The STD treatment consisted of long-course RT (28–25×1.8–2.0 Gy) and concurrent capecitabine, followed by surgery after 8☒ weeks. ![]() Within 2 to 4 weeks after this treatment, TME surgery was performed. The EXP treatment consisted of 5×5 Gy RT, followed by 6 cycles of CAPOX or 9 cycles of FOLFOX4. Moreover, survival after an LRF was analyzed. ![]() ![]() The aim was to investigate the rate and describe patterns of LRFs, including LRRs, in the experimental (EXP) and the standard-care (STD) treatment groups in the RAPIDO trial. In patients who undergo an R0 or R1 resection, an LRF may occur during follow-up as an locoregional recurrence (LRR). In poor or nonresponders to the neoadjuvant treatment, the tumor may be irresectable or lead to an R2 resection causing an early LRF (eLRF). LRF can occur at different time points during rectal cancer management using TNT. 4 However, less is known about locoregional failure (LRF) rates after TNT. Recently, the results of the RAPIDO trial demonstrated that preoperative short-course radiotherapy (scRT) followed by systemic chemotherapy (ie, TNT) resulted in a decreased disease-related treatment failure (DrTF) rate (mainly by a decrease in DM compared with standard CRT at 3 years of follow-up in high-risk locally advanced rectal cancer). The concept of total neoadjuvant treatment (TNT) was introduced to address the distant metastasis (DM) rate. 1– 3 Despite these improvements, the systemic relapse rate has remained largely unaltered. Over the past decades, improved imaging, preoperative radiotherapy (RT) or conformal radiotherapy (CRT), and total mesorectal excision (TME) surgery have resulted in improved local control rates in patients with rectal cancer. ![]()
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