ASTRO releases updated rectal cancer radiation therapy guideline

The American Society for Radiation Oncology (ASTRO) has released an updated radiation therapy guideline for rectal cancer.

The guideline was published November 25 in Practical Radiation Oncology. It includes new data on patient selection and best practices from clinical trials published since the prior guideline was issued in 2020, the society said.

Key recommendations include the following:

• Neoadjuvant radiation therapy is recommended for patients with stage II or III rectal cancer to reduce their risk of locoregional recurrence rather than after surgery.
• Organ preservation through total neoadjuvant therapy followed by nonoperative management, or neoadjuvant chemoradiation followed by local excision, may present alternatives to radical surgery for select patients.
• Updated recommendations also describe regimens to treat patients at higher risk of recurrence who would likely benefit from an intensified treatment approach.

The guideline is a collaboration between ASTRO and the American Society of Clinical Oncology (ASCO) and the Society of Surgical Oncology (SSO), and it is endorsed by the European Society for Radiotherapy and Oncology (ESRO) and the Royal Australian and New Zealand College of Radiologists (RANZCR).