Recommendation ID
Treatment of patients with moderate-risk locally advanced rectal cancer:- The effectiveness of preoperative chemotherapy should be compared with short-course preoperative radiotherapy (SCPRT), chemoradiotherapy or surgery alone in patients with moderate-risk locally advanced rectal cancer. Outcomes of interest are local control, toxicity, overall survival, quality of life and cost effectiveness.
Any explanatory notes
(if applicable)
Why this is important:- Variation exists as to whether or not patients with moderate-risk locally advanced rectal cancer are offered a preoperative treatment or not. If they are offered treatment, variation also exists as to whether it is with SCPRT or chemoradiotherapy. At present, preoperative chemotherapy, without radiotherapy, is limited to use in clinical trials. Patients with moderate-risk locally advanced rectal cancer are at risk of both local recurrence and systemic relapse, but the use of either form of radiotherapy carries the risk of significant morbidity, which may affect quality of life. It is therefore important to establish whether better outcomes can be achieved with preoperative chemotherapy or surgery alone, and whether there are groups of patients whose benefit from either SCPRT or chemoradiotherapy is greater than the risk of late effects.

Source guidance details

Comes from guidance
Colorectal cancer: diagnosis and management
Date issued
November 2011

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 06/01/2015