Lancet Gastroen Hepatol: Short-term radiotherapy combined with endoscopic microscopic surgery to treat early rectal cancer

Whole rectal system membrane root surgery excision is the standard treatment for local rectal cancer, although intestinal membrane excision can effectively control the tumor, but the patient's long-term intestinal, bladder and sexual dysfunction after surgery on the patient's quality of life (QOL) has a negative impact.
background, researchers recently examined the effects of organ-based treatment strategies on patient disease control and quality of life.
TREC study conducted in 21 medical centres in the UK involving adult rectal adenocarcinoma patients with tumor stages T2 and below, tumors with a maximum diameter of no more than 30mm, no lymph nodes affected or metastasis, random organ protection treatment strategies or whole rectal membrane removal Patients in the organ protection treatment strategy group receive 8-10 weeks of short-term radiotherapy, followed by endoscopic microscopic surgery, if the pathology test of endoscopic microscopy samples indicates an increased risk of local recurrence, a full rectal membrane removal is performed.
the main endpoints of the study were the therapeutic effectiveness, safety and quality of life of patients assessed 12, 18 and 24 months after surgery.
55 patients were involved in the study, including 27 in the organ protection treatment strategy group and 28 in the whole rectal membrane removal group.
30 days after the operation, no patients died, but one patient in the organ protection group died six months after the operation after being removed from the whole rectal system.
27 patients in the organ protection group, 8 underwent a full rectal membrane removal (30%).
of the 27 patients in the organ protection group, 4 (15%) reported serious adverse events, while 11 of the 28 patients in the whole rectal membrane removal group reported serious adverse events (39%).
the most common adverse events in the organ protection group were rectal bleeding or pain after endoscopic microscopy, and the most common adverse events in the whole rectal membrane removal group were consumable fistula, kidney damage, cardiac arrest and pneumonia.
27 patients in the organ protection group, 8 responded to radiotherapy (30%).
the whole rectal membrane excision group in terms of intestinal toxicity, quality of life and functional score, the effect lasted until 36 months.
study concluded that for patients with early rectal cancer, short-term radiotherapy after endoscopic microscopic surgery in disease control is comparable to the whole rectal membrane excision, but in patients with improved quality of life is better than the whole rectal membrane excision.