Perineal wound healing after short-course radiotherapy followed by chemotherapy and TME - RAPIDO-trial

locally advanced rectal caner perineal wound healing

Prof. dr. G.A.P. Hospers
Dr. B. van Etten
E.A. Dijkstra
P. Nilsson

Nature of the research:
Descriptive research of a international, randomized study, the RAPIDO-trial

Fields of study:
surgery oncology

Background / introduction
Perineal wound healing is often disturbed in locally advanced rectal cancer patients who underwent APR. As a consequence, delayed or disturbed perineal wound healing has an effect on the quality of life of patients. Previously conducted research demonstrated that delayed wound healing was associated with smoking, hypoalbuminemia, neoadjuvant (chemo)radiotherapy and flap reconstructive1,2. As demonstrated, disturbed perineal wound healing is associated with neoadjuvant chemoradiotherapy. However, the current and most used treatment for locally advanced rectal cancer is long-course chemoradiotherapy followed by surgery. In the RAPIDO-trial, the experimentally treated patients received short-course (5x5 Gy) radiotherapy followed-by chemotherapy and thereafter surgery3. In this trial we demonstrated that this new treatment corresponds to less distant metastasis. In addition, we state that this experimental treatment should be the new standard of care. Therefore it is important to know how perineal wounds heal and if delayed or disturbed perineal wound healing occurs more or less than the currently standard-care treatment.
Research question / problem definition
Are there differences in perineal wound healing after an (el)APR in patients treated with the experimental treatment or standard-care treatment in the RAPIDO trial?
Holm et al. Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer. Br J Surg 2007;94:232-238
Althumairi et al. Predictors of perineal wound complications and prolonged time to perineal wound healing after abdominoperineal resection. World J Surg 2016;40:1755-1762
Nilsson et al. Short-course radiotherapy followed by neo-adjuvant chemotherapy in locally advanced rectal cancer – the RAPIDO trial. BMC Cancer 2013;13:279
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