"A new study from Karolinska Institutet in Sweden shows that shortcourse preoperative radiotherapy combined with delayed surgery reduces the adverse sideeffects of rectal cancer surgery without compromising its efficacy. The results are presented in the journal The Lancet Oncology. Rectal cancer affects some  men and women in Sweden every year. Preoperative radiotherapy was gradually introduced in the early s with a consequent improvement in prognosis for people with rectal cancer and reduction in the risk of local recurrence.  Back then we showed that preoperative radiotherapy reduces the risk of local recurrence by over  per cent for patients with rectal cancer says principal investigator Anna Martling senior consultant surgeon and professor at Karolinska Institutets Department of Molecular Medicine and Surgery. Thanks to our results radiotherapy is recommended to many rectal cancer patients.  However radiotherapy can cause adverse reactions and the optimal radiotherapeutic method and the interval between it and the ensuing surgery have been mooted. The study now presented in The Lancet Oncology is based on the claim that the adverse effects of rectal cancer treatment can be reduced by administering more but lower doses of radiation for a longer time or by increasing the interval between radiotherapy and surgery. These hypotheses have now been tested in a study in which rectal cancer patients were randomly assigned to three different treatment arms  Standard therapy i.e. shortcourse x Gy radiotherapy with direct surgery within a week.   Delayed surgery with shortcourse x Gy radiotherapy followed by surgery after  weeks.   Delayed surgery with longcourse x Gy radiotherapy followed by surgery after  weeks. The results of the study show that patients with delayed surgery develop fewer complications with equally good oncological outcomes. It also showed that there is no difference between longcourse and shortcourse radiotherapy other than that the former considerably lengthens the time for treatment. The results of the study will give rise to improved therapeutic strategies fewer complications with a sustained low incidence of local recurrence and better survival rates for rectal cancer patients says Professor Martling. The results can now be immediately put to clinical use to the considerable benefit of the patients.  Eighteen Swedish hospitals took part in the study which was financed by the Swedish Research Council and the Cancer Society in Stockholm and through the regional ALF agreement between Stockholm County Council and Karolinska Institutet. Researchers from the universities in Lund Uppsala and Linkping also contributed to findings.  Publication The Stockholm III Trial on optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer  a randomised controlled trial Johan Erlandsson Torbjrn Holm David Pettersson ke Berglund Bjrn Cedermark Calin Radu Hemming Johansson Mikael Machado Fredrik Hjern Olof Hallbk Ingvar Syk Bengt Glimelius Anna Martling The Lancet Oncology online  February  DOI httpdx.doi.org.S"