Three Perspectives: The Approach of Neoadjuvant Treatment of Rectum Cancer According to Medical Oncologists, Radiation Oncologists, and Surgeons

Abstract Purpose Two treatment options are considered for radiotherapy: short-course radiotherapy and immediate surgery or chemoradiation with 5-Fluorouracil based chemotherapy with delayed surgery. We try to evaluate the real-life treatment approaches of medical, radiation, and surgical oncologists for neoadjuvant treatment of rectal cancers. MethodThe online survey form was established via Google Forms. The survey was taken voluntarily by medical oncologists, radiation oncologists, surgical oncologists, and general surgeons.Results One hundred eighty-three of the participants were medical oncologists while 36 were radiotherapists and 36 were surgeons. Most of the study population preferred long-course radiation therapy and chemotherapy (85%). Two-thirds of the participants preferred chemotherapy before operation. The most frequent chemotherapy cycles for the pre-operative setting were ‘three’ or ‘four-or-more’. (27,8% and 25,1% respectively) Medical oncologists had a significantly higher tendency of offering chemotherapy between radiation therapy and surgery compared with the other groups. The optimal time of surgery was different between groups. There was no difference among groups between surgery and the ‘watch & wait’ strategy. Neoadjuvant chemotherapy regimens were different between groups significantly.ConclusionWe found the new pre-operative chemotherapy regimen with short-course radiotherapy was slowly adopted in current practice. Also, medical oncologists tend pre-operative chemotherapy compared with other groups.