Related Experiment Video
Updated: Jun 9, 2025
12:45
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
5.6K
Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Insights from the Western Australian Context
Oliver Oey1,2, Chak Pan Lin3, Muhammad Adnan Khattak4
1UWA Medical School, University of Western Australia, Perth, WA 6009, Australia.
Diseases (Basel, Switzerland)
|October 25, 2024
Summary
Total neoadjuvant therapy (TNT) shows promise for locally advanced rectal cancer (LARC), demonstrating good tolerability and high R0 resection rates. Further research is needed to optimize TNT protocols and identify ideal patient candidates for this treatment.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Total neoadjuvant therapy (TNT) is increasingly associated with improved outcomes in locally advanced rectal cancer (LARC).
- Real-world data on the efficacy and safety of TNT for LARC is limited.
- TNT may enhance treatment adherence and reduce toxicity compared to conventional therapies.
Purpose of the Study:
- To evaluate the efficacy and safety of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer (LARC).
- To assess clinical and pathological response rates, R0 resection, and tolerability of TNT in a real-world setting.
- To compare outcomes between different TNT sequencing strategies.
Main Methods:
- Retrospective analysis of 32 LARC patients treated with TNT (induction chemotherapy followed by chemoradiotherapy or vice versa) at two Western Australian hospitals.
- Assessment of clinical response (complete, partial, none), pathological complete response (pCR), and R0/R1 resection rates.
- Evaluation of treatment tolerability, including adverse events and completion rates.
Main Results:
- A high R0 resection rate (100%) was achieved in 27 surgically treated patients.
- 15% pathological complete response (pCR) and 28% complete clinical response rates were observed.
- TNT was well-tolerated, with 88% of patients experiencing only grade 1-2 adverse effects.
Conclusions:
- Total neoadjuvant therapy (TNT) is a viable and well-tolerated approach for managing locally advanced rectal cancer (LARC).
- TNT demonstrates promising efficacy, including high R0 resection rates and acceptable pCR rates.
- Further research is essential to optimize TNT protocols and identify patient subgroups who benefit most.
