Treatments
PATHOLOGY, SECONDARY, STD
The EXP treatment consisted of 5×5 Gy RT, followed by 6 cycles of CAPOX or 9 cycles of FOLFOX4. Within 2 to 4 weeks after this treatment, TME surgery was performed. The STD treatment consisted of long-course RT (28–25×1.8–2.0 Gy) and concurrent capecitabine, followed by surgery after 8±2 weeks. According to hospital policy, patients in the STD group could receive postoperative 8 cycles of CAPOX or 12 cycles of FOLFOX4. RT target volumes did not differ between the EXP and STD groups. The results from the primary and some secondary endpoints of the RAPIDO trial have been reported.Restaging was performed in the EXP group 1 to 2 weeks after the last chemotherapy cycle and 2 to 3 weeks before planned surgery in the STD group. Restaging was performed by computed tomography (CT) of the thorax, abdomen, and pelvis and MRI of the pelvis. In the EXP group, an additional MRI of the pelvis was recommended in the middle of the neoadjuvant chemotherapy (week 12–14) to disclose any signs of progression. Treatment response was assessed after neoadjuvant treatment (based on baseline and restaging MRI reports) and after surgery (based on pathology reports). For this report, all patients with a decrease in T-stage and/or N-stage compared with baseline MRI stage were defined as good responders (ie, downstaging was accomplished).