Stockholm blues.

The Stockholm III trial compared short-course radiation (SRT, 25 Gy in 5 fractions) with immediate surgery (within 1 week), SRT with a 4-8 week delay to surgery (SRT), and long-course radiation (LRT, 50 Gy in 25 fractions) with delayed surgery. Time to local recurrence was non-inferior with SRT, and post-op complications with SRT + delay were similar to LRT and less than with immediate surgery. This secondary analysis compares tumor regression among treatment arms according to the interval between radiation and surgery. Patients who received SRT with delay to surgery had higher pCR rates, higher tumor regression grade, and lower yp-stage compared to both SRT with immediate surgery and LRT with delayed surgery. The pCR rate was 0.3% for SRT, 2.2% with LRT, and 10.4% with SRT and delay. TBL: In line with the above study, it takes at least 4 weeks to see pCR’s from SRT and the rate of pCR is higher than with long-course radiation alone. | Erlandsson, Radiother Oncol 2020

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