Radiotherapy for Rectal Cancer

To the Editor: Kapiteijn et al. (Aug. 30 issue) 1 reported that short-term preoperative radiotherapy reduces the risk of local recurrence in patients with rectal cancer who undergo standardized total mesorectal excision. There was no survival advantage. Similarly, a study that compared postoperative radiotherapy and chemotherapy with chemotherapy alone found a decreased risk of local recurrence and no survival advantage. 2 If radiotherapy results in minimal or no survival advantage, then the real question is whether it improves the quality of life. Kapiteijn et al. mention the long-term effects of preoperative radiotherapy on bowel function only briefly, by referring to one study . . .