IMRT

compared to chemoRT for T3-4 rectal cancer: a multicentric randomized trial

Conclusions:

 The use of image-guided and intensity-modulated radiotherapy (IG-IMRT) results in very low rates of acute grade 3 toxicity in both arms (6% vs 4%)

 IMRT improves significantly the tolerance of preoperative RT for rectal cancer, especially radiation enteritis

 Higher pCR rates are observed in the chemo-RT arm (24% vs 14% in the RT-SIB arm), no differences in major tumoral downstaging

 Difference in SUVmax reduction -2.9% in favor of chemoRT (95% CI, -10.1% to 4.3%, p = 0.06) => RT-SIB marginally failed to prove non-inferiority to chemoRT

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