This Cochrane review assesses the efficacy of pre-operative chemoradiation (CRT) with radiotherapy (RT) alone before surgery in the treatment of locally advanced, non-metastatic rectal surgery. 6 randomised controlled trials eligible for inclusion. A reduction in local recurrence was seen in the CRT group in comparison to the RT group. The 30 day mortality was the same for both groups as was sphincter preservation measured by stoma rate. An increase in acute grade 3/4 treatment related toxicity was seen in the CRT group, but late toxicity events were similar.

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