Published: 22-05-2019 14:17 | Updated: 22-05-2019 14:24

New thesis on different radiotherapy courses in patients with rectal cancer

Johan Erlandsson from the group Colorectal Surgery will defend his thesis "Preoperative radiotherapy in rectal cancer : aspects on fractionation and timing of surgery" on May 24, 2019. Main Supervisor is Anna Martling.

Johan Erlandsson, photo: Evelina Erlandsson

What's the main focus of your thesis?

Colorectal cancer is a common form of cancer. In Sweden more than 2000 patients are diagnosed yearly. The focus of this thesis is different radiotherapy courses in patients with rectal cancer. Preoperative radiotherapy reduces the risk of a local recurrence with 50%. In Sweden patients have often gone through a short course with 5 days of radiotherapy and surgery the following week. A large Swedish multicentre trial randomly assigned 840 patients to three different radiotherapy schedules and this is the foundation of my doctoral studies and this thesis.

Which are the most important results?

From an oncological point of view, it seems safe to delay surgery for 4-8 weeks after a short radiotherapy course. We found no statistical significant differences in the incidence of local- or distant recurrence or survival between the randomisation arms. The rate of postoperative complications was however reduced if surgery was delayed after radiotherapy. Further, patients with delayed surgery after a short radiotherapy course had a higher probability of complete tumour regression, i.e no tumour left after radiotherapy. These patients have an excellent prognosis. 

How can this new knowledge contribute to the improvement of people's health?

The increased knowledge about the safety and potential benefits of the short radiotherapy course with a delay to surgery may be used to optimise the treatment in patients with rectal cancer. The waiting interval can be used to improve the conditions for surgery even further for instance smoking cessation or correction of anaemia when needed.

What are your future ambitions?

Research on colorectal cancer covers many different aspects and the knowledge on different treatment forms is constantly increasing. Ambitions for the future includes individualised treatment by identifying patient specific factors that may predict response on a given treatment. Other interesting topics are different organs preserving strategies in patients with a complete tumour response after radiation therapy.


Friday, May 24th 2019 at 09:00, Nanna Svartz J3:12, Karolinska University Hospital, Solna


Preoperative radiotherapy in rectal cancer : aspects on fractionation and timing of surgery