Chemoradiotherapy intensification in rectal cancer: lessons from the ARISTOTLE trial
Mené sur 589 patients atteints d'un cancer du rectum localement avancé (durée médiane de suivi : 79 mois ; âge médian : 61 ans ; 66 % d'hommes), cet essai randomisé multicentrique de phase III évalue l'intérêt, du point de vue de la survie sans maladie, d'un ajout d'irinotécan à une chimioradiothérapie à base de fluoropyrimidine
Preoperative fluoropyrimidine-based chemoradiotherapy constituted the cornerstone in the management of locally advanced rectal cancer for more than two decades. Randomised trials established chemoradiotherapy followed by total mesorectal excision surgery as a standard approach, improving local control compared with radiotherapy alone and offering advantages, especially with regard to toxicity, over postoperative chemoradiotherapy. Despite these advances, distant metastases remained the predominant cause of treatment failure. As such, several trials assessed the potential of intensified concomitant chemotherapy combined with chemoradiotherapy to enhance systemic disease control and improve long-term outcomes.
The Lancet Oncology , commentaire, 2026