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Related Experiment Video

Updated: May 12, 2026

Intestinal Epithelial Regeneration in Response to Ionizing Irradiation
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Intestinal Epithelial Regeneration in Response to Ionizing Irradiation

Published on: July 27, 2022

Acute Toxicity From Short-Course Radiation Therapy for Rectal Cancer: A Single-Institution Experience.

Shane S Neibart1, Katie N Lee2, Yu-Hui Chen3

  • 1Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.

Advances in Radiation Oncology
|May 11, 2026
PubMed
Summary

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Short-course radiation therapy (SCRT) for rectal cancer causes acute toxicity in 75% of patients, including a transient lumbosacral plexopathy (ALSP) in 14%. These effects were temporary and did not lead to long-term issues.

Area of Science:

  • Oncology
  • Radiation Oncology
  • Gastrointestinal Oncology

Background:

  • Short-course radiation therapy (SCRT) is a key neoadjuvant treatment for locally advanced rectal cancer.
  • While offering logistical benefits over long-course chemoradiation, SCRT's long-term outcomes and adverse effects require further investigation.
  • Acute toxicities, including acute lumbosacral plexopathy (ALSP), are not fully understood.

Purpose of the Study:

  • To examine acute toxicities following SCRT for locally advanced rectal cancer.
  • To specifically investigate the incidence and characteristics of acute lumbosacral plexopathy (ALSP) after SCRT.
  • To compare dosimetric and clinicodemographic variables between patients with and without ALSP.

Main Methods:

  • Retrospective analysis of 71 patients with locally advanced rectal cancer treated with neoadjuvant SCRT (25 Gy/5 fractions) between 2016-2022.

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  • Acute toxicity assessed up to 30 days post-SCRT; ALSP defined as pelvic/buttock pain with potential leg radiation.
  • Matched case-control analysis comparing patients with and without ALSP, including dosimetric evaluation of the lumbosacral plexus.

    • Main Results:

    • 75% of patients experienced any-grade acute toxicity within 30 days of SCRT.
    • 14% (10 patients) developed ALSP, presenting early (median 2.5 days) and resolving within a week.
    • ALSP was transient in all cases and not linked to specific dosimetric parameters or muscle composition.

    Conclusions:

    • SCRT for rectal cancer is associated with significant acute toxicity, with ALSP affecting 14% of patients.
    • Observed ALSP cases were transient and resolved without late sequelae, emphasizing the need for monitoring beyond the treatment period.
    • Further research is needed to identify ALSP predictors and develop mitigation strategies for SCRT-induced toxicities.