Title: Predictors of pathological complete response after total neoadjuvant treatment using short
course radiotherapy for locally advanced rectal cancer
Version: 1 Date: 14 Dec 2024
Reviewer's report:
Yacoub H. et al report a retrospective single center study of 91 patients with locally advanced
rectal cancer with chemotherapy and radiation. Comparing two approaches, chemotherapy
followed by short course radiation had improved complete pathological response (pCR) rate
compared to patients who were treated with short course radiation followed by chemotherapy
(RAPIDO protocol). On a multivariate analysis, they identified chemotherapy interruption and
the presence of mucinous features to be significant predictors of pCR.
Comments:
1. There are several grammatical and syntax errors throughout the manuscript. It would be best
for the manuscript to be reviewed and edited by a professional language service or a native
English speaker.
2. The authors need to describe their selection criteria for chemoradiation followed by
chemotherapy and vice versa as this might have introduced biases that impact the ability to draw
conclusions on oncologic outcomes.
3. The authors should comment on whether they implement watch and wait approaches as this
has rapidly evolved and incorporated in the management of rectal cancer. This is an important
point that needs to be addressed given the quality of life implications for patients with rectal
cancer.
4. The authors only utilized short course radiotherapy however do not comment on the utilization
of long course radiotherapy which has been shown to be associated with less locoregional
recurrences. This is an important consideration given the previously reported high rates of pCR
after long course chemoradiation followed by chemotherapy.
Title: Predictors of pathological complete response after total neoadjuvant treatment using short
course radiotherapy for locally advanced rectal cancer
Version: 1 Date: 14 Dec 2024
Reviewer's report:
Yacoub H. et al report a retrospective single center study of 91 patients with locally advanced
rectal cancer with chemotherapy and radiation. Comparing two approaches, chemotherapy
followed by short course radiation had improved complete pathological response (pCR) rate
compared to patients who were treated with short course radiation followed by chemotherapy
(RAPIDO protocol). On a multivariate analysis, they identified chemotherapy interruption and
the presence of mucinous features to be significant predictors of pCR.
Comments:
1. There are several grammatical and syntax errors throughout the manuscript. It would be best
for the manuscript to be reviewed and edited by a professional language service or a native
English speaker.
2. The authors need to describe their selection criteria for chemoradiation followed by
chemotherapy and vice versa as this might have introduced biases that impact the ability to draw
conclusions on oncologic outcomes.
3. The authors should comment on whether they implement watch and wait approaches as this
has rapidly evolved and incorporated in the management of rectal cancer. This is an important
point that needs to be addressed given the quality of life implications for patients with rectal
cancer.
4. The authors only utilized short course radiotherapy however do not comment on the utilization
of long course radiotherapy which has been shown to be associated with less locoregional
recurrences. This is an important consideration given the previously reported high rates of pCR
after long course chemoradiation followed by chemotherapy.
Please review this paper.
user
Title: Predictors of pathological complete response after total neoadjuvant treatment using short
course radiotherapy for locally advanced rectal cancer
Version: 1 Date: 14 Dec 2024
Reviewer's report:
Yacoub H. et al report a retrospective single center study of 91 patients with locally advanced
rectal cancer with chemotherapy and radiation. Comparing two approaches, chemotherapy
followed by short course radiation had improved complete pathological response (pCR) rate
compared to patients who were treated with short course radiation followed by chemotherapy
(RAPIDO protocol). On a multivariate analysis, they identified chemotherapy interruption and
the presence of mucinous features to be significant predictors of pCR.
Comments:
1. There are several grammatical and syntax errors throughout the manuscript. It would be best
for the manuscript to be reviewed and edited by a professional language service or a native
English speaker.
2. The authors need to describe their selection criteria for chemoradiation followed by
chemotherapy and vice versa as this might have introduced biases that impact the ability to draw
conclusions on oncologic outcomes.
3. The authors should comment on whether they implement watch and wait approaches as this
has rapidly evolved and incorporated in the management of rectal cancer. This is an important
point that needs to be addressed given the quality of life implications for patients with rectal
cancer.
4. The authors only utilized short course radiotherapy however do not comment on the utilization
of long course radiotherapy which has been shown to be associated with less locoregional
recurrences. This is an important consideration given the previously reported high rates of pCR
after long course chemoradiation followed by chemotherapy.
assistant