{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:30:37Z","timestamp":1772580637391,"version":"3.50.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neoadjuvant conventional chemoradiation (CRT) is the standard treatment for primary locally non-curatively resectable rectal cancer, as tumor downsizing may allow R0 resectability. Short-term neoadjuvant radiotherapy (5x5 Gy) followed by an interval before surgery (SRT- delay) is an alternative for multimorbid patients who cannot tolerate CRT. This study examined the extent of tumor downsizing achieved with the SRT-delay approach in a limited cohort that underwent complete re-staging before surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between March 2018 and July 2021, 26 patients with locally advanced primary adenocarcinoma (&amp;gt;uT3 or\/and N+) of the rectum were treated with SRT-delay. 22 patients underwent initial staging and complete re-staging (CT, endoscopy, MRI). Tumor downsizing was assessed by staging and re-staging data and pathologic findings. Semiautomated measurement of tumor volume was performed using mint Lesion\u2122 1.8 software to evaluate tumor regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean tumor diameter determined on sagittal T2 MRI images decreased significantly from 54.1 (23\u201378) mm at initial staging to 37.9 (18\u201365) mm at re-staging before surgery (p &amp;lt;0.001) and to 25.5 (7\u201358) mm at pathologic examination (p &amp;lt;0.001). This corresponds to a mean reduction in tumor diameter of 28.9 (4.3\u201360.7) % at re-staging and 51.1 (8.7\u201386.5) % at pathology. Mean tumor volume determined from transverse T2 MR images mint Lesion<jats:sup>TM<\/jats:sup> 1.8 software significantly decreased from 27.5 (9.8 \u2013 89.6) cm<jats:sup>3<\/jats:sup> at initial staging to 13.1 (3.7 \u2013 32.8) cm<jats:sup>3<\/jats:sup> at re-staging (p &amp;lt;0.001), corresponding to a mean reduction of 50.8 (21.6 \u2013 77) %. The frequency of positive circumferential resection margin (CRM) (less than 1mm) decreased from 45,5 % (10 patients) at initial staging to 18,2 % (4 patients) at re-staging. On pathologic examination, the CRM was negative in all cases. However, multivisceral resection for T4 tumors was required in 2 patients (9%). Tumor downstaging was noted in 15 of 22 patients after SRT-delay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, the observed extent of downsizing is broadly comparable to the results of CRT, making SRT-delay a serious alternative for patients who cannot tolerate chemotherapy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1106177","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T07:31:52Z","timestamp":1676619112000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Downsizing of rectal cancer following neoadjuvant radiotherapy (5\u2009\u00d7\u20095 Gy) and long interval surgery evaluated using MRI semiautomated volumetric measurements, a retrospective study"],"prefix":"10.3389","volume":"10","author":[{"given":"Hendrik Christian","family":"Albrecht","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Sandbrink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Gretschel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1001\/archsurg.133.8.894","article-title":"Rectal cancer: the basingstoke experience of total mesorectal excision, 1978\u20131997","volume":"133","author":"Heald","year":"1998","journal-title":"Arch Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1056\/NEJM199704033361402","article-title":"Improved survival with preoperative radiotherapy in resectable rectal cancer","volume":"336","author":"Cedermark","year":"1997","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1056\/NEJMoa010580","article-title":"Dutch Colorectal cancer group. 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