Local recurrence rate in a randomised multicentre trial of preoperative radiotherapy compared with operation alone in resectable rectal carcinoma. Swedish Rectal Cancer Trial.
OBJECTIVE: To find out whether short-term high-dose preoperative radiotherapy can reduce local recurrence rate without increasing postoperative mortality in patients with resectable rectal cancer. DESIGN: Randomised trial. SETTING: Nationwide Swedish multicentre trial. SUBJECTS: From March 1987 to February 1990, 1168 patients were randomised. In each group, 454 patients had curative surgery. INTERVENTIONS: Patients were allocated to preoperative irradiation (25 Gy in five fractions in one week) followed by operation within a week, or to surgery alone. MAIN OUTCOME MEASURES: Postoperative morbidity and mortality, and local recurrence rate. RESULTS: After a minimum follow-up of two years, 9% (51/553) of the patients in the irradiated group who had had the tumour resected had developed a local recurrence, compared with 24% (131/557) in the surgery alone group (p