{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:54:54Z","timestamp":1790736894490,"version":"4.1.0"},"reference-count":16,"publisher":"Korean Society for Therapeutic Radiology and Oncology","issue":"3","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2024-00349635"],"award-info":[{"award-number":["RS-2024-00349635"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-roj.org"],"crossmark-restriction":true},"short-container-title":["Radiat Oncol J"],"published-print":{"date-parts":[[2026,9,30]]},"abstract":"<jats:p>Purpose: Total mesorectal excision (TME) is the standard treatment for early rectal cancer, but radiation therapy (RT) with or without chemotherapy may be considered as an alternative organ-preserving option. This study evaluated the oncologic outcomes, patterns of failure, salvage treatment efficacy, and TME\u2013free survival (TME-FS) following RT without radical surgery after local excision or biopsy in selected patients.Materials and Methods: We retrospectively analyzed 40 patients with cT1\u20132N0 rectal adenocarcinoma who received RT after local excision or biopsy without subsequent radical surgery between 2007 and 2023. Indications for RT included clinical T1 disease with high-risk features, clinical T2 disease, or tumors located close to the anal verge. The median RT dose was 50.2 Gy, and 29 patients received chemotherapy. Survival outcomes, recurrence patterns, salvage treatments, toxicities, and TME-FS were assessed.Results: The median follow-up was 38 months. The 5-year overall survival rates were 87.5% for the cT1 group and 85.6% for the cT2 group, and the 5-year cancer-specific survival rate was 100% in both groups. The 5-year recurrence-free survival rates were 79.3% and 62.8%, respectively. Overall, nine patients experienced treatment failure, and four patients ultimately underwent salvage TME. The 5-year TME-FS were 87.5% in the cT1 group and 78.6% in the cT2 group. No grade 2 or higher late toxicities were observed.Conclusion: RT without radical surgery may be a feasible treatment option for cT1\u20132N0 rectal cancer patients who are unsuitable for, or decline, radical surgery. Close surveillance and timely salvage treatment remain essential, particularly for those with cT2 disease.<\/jats:p>","DOI":"10.3857\/roj.2026.00633","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T22:53:31Z","timestamp":1788476011000},"page":"222-230","update-policy":"https:\/\/doi.org\/10.3857\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes of radiation therapy as an alternative to radical surgery for early-stage rectal cancer"],"prefix":"10.3857","volume":"44","author":[{"given":"Seo Jin","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwa Kyung","family":"Byun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee Suk","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seo Hee","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo Joong","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woong Sub","family":"Koom","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2224","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3393\/ac.2021.00479.0068","type":"journal-article"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2018.08.024","type":"journal-article"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/dcr.0b013e3181a0adbd","type":"journal-article"},{"key":"ref4","volume-title":"NCCN guidelines for rectal cancer (version 2.2026) 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study","author":"Bhangu","year":"2013"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/dcr.0000000000001762","type":"journal-article"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.4174\/astr.2022.102.1.36","type":"journal-article"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10163","type":"journal-article"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4065-5","type":"journal-article"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2021.62.12.1107","type":"journal-article"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1159\/000489930","type":"journal-article"}],"container-title":["Radiation Oncology Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-roj.org\/upload\/pdf\/roj-2026-00633.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-roj.org\/journal\/view.php?doi=10.3857\/roj.2026.00633","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-roj.org\/upload\/pdf\/roj-2026-00633.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:04:34Z","timestamp":1790733874000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-roj.org\/journal\/view.php?doi=10.3857\/roj.2026.00633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.3857\/roj.2026.00633","relation":{},"ISSN":["2234-1900","2234-3156"],"issn-type":[{"value":"2234-1900","type":"print"},{"value":"2234-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2026-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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