The RAPIDO trial compared short-course preoperative radiotherapy (5 × 5 Gy) followed by systemic chemotherapy then surgery versus standard chemoradiotherapy then surgery for locally advanced rectal cancer. The primary endpoint showed superior results in the experimental arm for:
- A Overall survival
- B Pathological complete response rate was not significantly different
- C Disease-related treatment failure at 3 years (distant metastases + local recurrence) ✓
- D Quality of life and sphincter preservation rate
Correct answer: C. Disease-related treatment failure at 3 years (distant metastases + local recurrence)
Explanation
The RAPIDO trial demonstrated that short-course radiotherapy followed by consolidation chemotherapy (CAPOX or FOLFOX4) then surgery achieved a significantly lower 3-year disease-related treatment failure rate compared to standard long-course chemoradiotherapy (23.7% vs 30.4%, HR 0.75). Notably, pathological complete response (pCR) was also significantly improved (28% vs 14%). Overall survival was not significantly different at the time of publication.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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