Phase III Randomized Study of Preoperative Radiotherapy Versus Selective Postoperative Chemoradiotherapy in Patients With Operable Rectal Cancer. Note: The information about this trial has not been updated by the sponsor/principal investigator/lead organization. cannot verify the accuracy of the information.

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Alternate Title

Radiation Therapy Before Surgery Compared With Chemotherapy Plus Radiation After Surgery in Treating Patients With Rectal Cancer That Can Be Surgically Removed. Note: The information about this trial has not been updated by the sponsor/principal investigator/lead organization. cannot verify the accuracy of the information.

Basic Trial Information

PhaseTypeStatusAgeSponsorProtocol IDs
Phase IIITreatmentClosed75 and underOtherMRC-CR07
EU-98008, CAN-NCIC-C016, ISRCTN28785842, NCT00003422, C016


  1. Compare local recurrence free rates and quality of life in patients with operable rectal cancer receiving preoperative radiotherapy versus patients receiving selective postoperative chemoradiotherapy.
  2. Determine local recurrence free survival, overall survival, time to appearance of distant metastases, disease free survival and morbidity in these patients.

Entry Criteria

Disease Characteristics:

  • Histologically confirmed adenocarcinoma of the rectum (defined as lower edge of tumor within 15 cm of anal verge)
  • Tumor considered potentially operable
  • No evidence of metastases indicated by liver ultrasound or CT scan; chest x-ray; or renal, liver, and bone profiles

Prior/Concurrent Therapy:

    Biologic therapy

  • Not specified


  • Not specified

    Endocrine therapy

  • Not specified


  • Not specified


  • Not specified

Patient Characteristics:


  • 75 and under

    Performance status:

  • Not specified

    Life expectancy:

  • Not specified


  • Not specified


  • Not specified


  • Not specified


  • No uncontrolled heart failure or angina


  • No other concurrent uncontrolled medical illness (e.g., infection)
  • No other prior or concurrent malignancy likely to interfere with the protocol treatments or comparisons

Expected Enrollment


Approximately 1800 patients will be accrued into this study.


Primary Outcome(s)

Local recurrence by biopsy, imaging, or imaging and carcinoembryonic antigen result

Secondary Outcome(s)

Local recurrence-free survival
Overall survival
Time to appearance of distant metastases
Disease-free survival
Quality of life
Economic implications


This is a randomized, multicenter study. Patients are stratified by a number of factors including surgeon.

Patients are randomized to receive preoperative radiotherapy (arm I) or postoperative chemoradiotherapy (arm II).

  • Arm I: Patients receive radiotherapy in 5 fractions over 1 week prior to surgery. Patients undergo surgery within 7 days of the last fraction of radiotherapy.
  • Arm II: Patients receive chemoradiotherapy 4-12 weeks after surgery (if circumferential resection margins are histologically involved by tumor). Radiotherapy is administered in 25 fractions over 5 weeks (5 days per week). During radiotherapy, patients either receive fluorouracil (5-FU) continuous infusion, 5-FU bolus IV and leucovorin calcium IV weekly, or a 5-day bolus schedule of 5-FU and leucovorin calcium.

Patients may then receive adjuvant chemotherapy as per local policy.

Quality of life assessments are made every 3 months for 1 year and then every 6 months for the next 2 years.

Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

Published Results

Stephens RJ, Thompson LC, Quirke P, et al.: Impact of short-course preoperative radiotherapy for rectal cancer on patients' quality of life: data from the Medical Research Council CR07/National Cancer Institute of Canada Clinical Trials Group C016 randomized clinical trial. J Clin Oncol 28 (27): 4233-9, 2010.[PUBMED Abstract]

Quirke P, Steele R, Monson J, et al.: Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet 373 (9666): 821-8, 2009.[PUBMED Abstract]

Sebag-Montefiore D, Stephens RJ, Steele R, et al.: Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373 (9666): 811-20, 2009.[PUBMED Abstract]

Quirke P, Sebag-Montefiore D, Steele R, et al.: Local recurrence after rectal cancer resection is strongly related to the plane of surgical dissection and is further reduced by pre-operative short course radiotherapy. Preliminary results of the Medical Research Council (MRC) CR07 trial. [Abstract] J Clin Oncol 24 (Suppl 18): A-3512, 2006.

Sebag-Montefiore D, Steele R, Quirke P, et al.: Routine short course pre-op radiotherapy or selective post-op chemoradiotherapy for resectable rectal cancer? Preliminary results of the MRC CR07 randomised trial. [Abstract] J Clin Oncol 24 (Suppl 18): A-3511, 2006.

Sebag-Montefiore D: An update report on the MRC CR07 trial. [Abstract] Br J Cancer 85 (suppl 1): A-9.3, 28, 2001.

Trial Contact Information

Trial Lead Organizations

Medical Research Council Clinical Trials Unit

R. Steele, Protocol chair
Ph: 44-1382-660-111

NCIC-Clinical Trials Group

Jean Couture, MD, Protocol chair (Contact information may not be current)
Ph: 514-466-5000

Registry Information

Official TitleA Randomised Trial Comparing Pre-Operative Radiotherapy and Selective Post-Operative Chemoradiotherapy in Rectal Cancer
Trial Start Date1998-01-01
Registered in ClinicalTrials.govNCT00003422
Date Submitted to PDQ1998-07-08
Information Last Verified2007-03-26

Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol.