The RAPIDO trial compared short-course radiotherapy (25 Gy/5 fractions) followed by systemic chemotherapy then surgery versus long-course chemoradiotherapy then surgery for locally advanced rectal cancer. The main finding was:
- A Short-course RT followed by chemotherapy significantly reduced 3-year disease-related treatment failure ✓
- B Short-course RT arm had superior R0 resection rates
- C Long-course CRT had higher pathological complete response rates
- D Both arms had equivalent pCR and distant failure rates
Correct answer: A. Short-course RT followed by chemotherapy significantly reduced 3-year disease-related treatment failure
Explanation
RAPIDO demonstrated that short-course RT (25 Gy) followed by CAPOX/FOLFOX4 chemotherapy and then surgery significantly reduced 3-year disease-related treatment failure (23.7% vs 30.4%) compared to long-course CRT plus optional adjuvant chemotherapy. pCR was also higher (28% vs 14%) in the experimental arm. This established total neoadjuvant therapy using short-course RT as a preferred strategy for high-risk locally advanced rectal cancer.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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