The RAPIDO trial compared short-course radiotherapy (SCRT) followed by chemotherapy then surgery versus long-course chemoradiotherapy then surgery for locally advanced rectal cancer. What was the main finding regarding pathological complete response (pCR)?
- A SCRT arm had significantly lower pCR rates
- B SCRT with consolidation chemotherapy achieved significantly higher pCR rates than long-course CRT ✓
- C Both arms had equivalent pCR rates
- D Long-course CRT had higher pCR but worse survival
Correct answer: B. SCRT with consolidation chemotherapy achieved significantly higher pCR rates than long-course CRT
Explanation
The RAPIDO trial (2021) demonstrated that the experimental arm of short-course radiotherapy (25Gy in 5 fractions) followed by 18 weeks of consolidation chemotherapy (CAPOX or FOLFOX) then surgery achieved a significantly higher pathological complete response rate (28% vs 14%) compared to standard long-course chemoradiotherapy followed by surgery. The SCRT-based total neoadjuvant therapy approach also reduced three-year disease-related treatment failure. This trial validated total neoadjuvant therapy (TNT) as a promising strategy for locally advanced rectal cancer.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.