The following is the summary of “Bowel Functional Outcomes After Long-Course or Short-Course Radiation for Advanced Rectal Cancers: A Propensity-Matched Analysis” published in December 2022 issue of Diseases of the Colon & Rectum by Kazi, et al.

Functional results relative to long-course radiation have not been examined, despite the growing popularity of short-course radiation and chemotherapy due to equal or better oncological outcomes. The purpose of this study was to evaluate the differences in bowel function recovery between patients with advanced rectal cancer who underwent either a long- or short-course radiation treatment followed by a delayed operation. Analysis of propensity scores. This investigation took place at a single, highly specialized cancer hospital. In-patient surgeries took place between the years 2014 and 2020. 

Patients in the study had low anterior resection with stapled anastomosis and diverting ostomy for locally advanced, nonmetastatic, mid and low rectal malignancies. Excisions of more than the entire mesorectum and dissections of the lateral lymph nodes were not included. Long-term radiation therapy (50 Gy in 25 fractions) or short-term radiation therapy (5 Gy in 5 fractions) followed by delayed surgery 4–6 weeks later with or without chemotherapy are the interventions. Wexner incontinence scores and low anterior resections syndrome grades were assessed once, at 6 months post-stoma reversal. The end result is that 93 individuals were included in the analysis out of 124 who were initially matched in a 1:2 ratio between short- and long-course radiations.  

About 90.3% of patients treated with a shorter length of radiation had symptoms of any low anterior resection syndrome, compared to 54.8% of those treated with a longer course of radiation (P<0.001). The percentage of patients who experienced major incontinence after receiving radiation therapy ranged from 6.5% after short-course radiation to 8.1% after receiving long-course radiation (P=0.781). Short-course radiation had an odds ratio (OR) of 4.4 in multivariate logistic regression for predicting the emergence of any low anterior resection syndrome. Unavoidable selection and misclassification biases in backward recruiting. Low anterior resection syndrome was more likely to occur after short-course radiation therapy compared to long-course radiation therapy in patients with locally advanced, nonmetastatic, mid- and low-stage rectal cancers who underwent preoperative radiation before undergoing stapled low anterior resection.