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A 2023 randomised study of 214 adults found only 0.9 lbs additional loss after three months compared to placebo not statistically significant

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Study population LARC within 12 cm from anal verge MRI-confirmed uninvolved MRF Median follow-up 48 months Treatment strategy CAPOX x4 cycles surgery Pelvic RT + capecitabine surgery Key 3-year outcomes LRRFS 97.4% (CRT) vs 96.3% (CAPOX) | HR 1.40 DFS 89.2% vs 87.9% | HR 0.88 OS 95.0% vs 94.1% | HR 0.86 Long-term toxicity matters Grade 2-4 late AEs 26.3% (CRT) vs 16.0% (CAPOX) Chronic proctitis 41.7% vs 33.6% Clinical interpretation Non-inferiority was not formally met due to extremely low event rates

Treating any detection window estimate as reliable protection is a significant risk