{"entity":{"id":"stockholm-iii","kind":"trial","name":"Stockholm III","aka":[],"tldr":"Waiting four to eight weeks after a short course of radiotherapy is as safe as operating immediately, and it gives time for the tumour to shrink.","summary":"Stockholm III randomised 840 patients from eighteen Swedish hospitals between short-course radiotherapy with immediate surgery, short-course radiotherapy with surgery delayed four to eight weeks, and long-course radiotherapy with delayed surgery. Local recurrence occurred in eight of 357, ten of 355 and seven of 128 patients respectively; both delayed arms were non-inferior (hazard ratio for short-course with delay 1.44, 95% CI 0.41 to 5.11; for long-course with delay 2.24, 0.71 to 7.10; p=0.48). Postoperative complications were fewer with delay. The trial made the delayed short course a legitimate option, which is what RAPIDO and STELLAR then built their total neoadjuvant schedules on and what allows organ preservation after a one-week course.","status":"positive","asOf":"2026-09-24","links":[{"label":"ClinicalTrials.gov NCT00904813","url":"https://clinicaltrials.gov/study/NCT00904813"},{"label":"Stockholm III: optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Lancet Oncology 2017)","url":"https://doi.org/10.1016/S1470-2045(17)30086-4"}],"tags":[],"related":[],"cancers":["colorectal","rectal-cancer"],"sections":[],"technologies":["imrt-igrt"],"targets":[],"drugs":[],"companies":[],"institutions":["karolinska"],"pathways":[],"terms":[],"trials":["rapido","stellar-rectal"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT00904813","phase":"3","setting":"Resectable rectal cancer: 5 x 5 Gy with surgery within a week, 5 x 5 Gy with surgery after four to eight weeks, or 25 x 2 Gy with delayed surgery","sponsor":"Karolinska Institutet","result":"Delaying surgery after 5 x 5 Gy is non-inferior for local recurrence and has fewer postoperative complications.","yearReported":2017,"enrolled":840,"enrolledBasis":"registry","outcomes":[{"endpoint":"Local recurrence","primary":true,"unit":"events","arms":[{"name":"Short-course, immediate surgery","n":357,"value":8},{"name":"Short-course, delayed surgery","n":355,"value":10},{"name":"Long-course, delayed surgery","n":128,"value":7}],"p":"0.48","source":"https://doi.org/10.1016/S1470-2045(17)30086-4"}]},"route":"/trials/stockholm-iii/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"rectal-cancer","kind":"cancer","name":"Rectal cancer","route":"/cancers/rectal-cancer/"}],"technology":[{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"institution":[{"id":"karolinska","kind":"institution","name":"Karolinska University Hospital","route":"/institutions/karolinska/"}],"trial":[{"id":"cao-aro-aio-94","kind":"trial","name":"CAO/ARO/AIO-94 (German Rectal Cancer Study)","route":"/trials/cao-aro-aio-94/"},{"id":"dutch-tme-trial","kind":"trial","name":"Dutch TME trial","route":"/trials/dutch-tme-trial/"},{"id":"rapido","kind":"trial","name":"RAPIDO","route":"/trials/rapido/"},{"id":"stellar-rectal","kind":"trial","name":"STELLAR (rectal cancer)","route":"/trials/stellar-rectal/"},{"id":"swedish-rectal-cancer-trial","kind":"trial","name":"Swedish Rectal Cancer Trial","route":"/trials/swedish-rectal-cancer-trial/"}]}}