Organ preserving treatment for rectal cancer patients

Foto AJM Rombouts.jpg

Not all rectal cancer patients need an operation. That was concluded by researchers from the Radboudumc after studying data from the Netherlands Cancer Registry (NKR).

The Radboudumc Centre for Oncology has started an international randomized trial (the STAR-TREC trial) investigating two organ preserving treatment strategies in rectal cancer patients. The first patient was included last week.
A paradigm shift is taking place in the treatment of patients with rectal cancer. Previously, all patients with rectal cancer underwent radical surgery. However, surgery for rectal cancer can be associated with urinary problems, faecal incontincence or the need for a stoma, and sexual dysfunction. Less radical treatment options are therefore explored with comparative outcomes. Patients with rectal cancer who have a good or complete response after neoadjuvant therapy can be candidates for organ preserving treatment regimens.

Anouk Rombouts
 (photo) and colleagues investigated predicting factors for pathological response in rectal cancer patients using data from the NKR. A complete response (meaning there were no vital tumor cells left in the resected specimen) was achieved in 10-20% of patients. Professor of surgical oncology Hans de Wilt from the Radboudumc: “We operate on almost all patients with rectal cancer, however, a rectum preserving approach might be feasible in these patients.”

The STAR-TREC trial is an international, randomized controlled trial between the United Kingdom, Denmark and the Netherlands. Standard surgery is compared with two organ preserving treatment regimens: short course radiation therapy or long course radiation therapy combined with chemotherapy. Within the Netherlands, there are 12 participating centers and the trial is coordinated from our center. Lead investigator Hans de Wilt: “STAR-TREC will show us whether the investigated organ preserving treatment regimens will lead to comparable oncological outcomes and which treatment modality gives the best results in the short and the long term.”

Participating centers STARTREC: Radboudumc, Isala, LUMC, Amphia, Catharina Ziekenhuis, AvL, VUmc, IJsselland Ziekenhuis, MC Leeuwarden, Elisabeth-TweeSteden Ziekenhuis, Diakonessenhuis and Laurentius Ziekenhuis.


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