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Total neoadjuvant therapy for locally advanced rectal cancer
Sophie Mueller1, Yung-Shuo Kao2, Carolin Kastner1
1Department of General, Visceral, Transplant, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
The Cochrane Database of Systematic Reviews
|May 14, 2025
Summary
This review will compare total neoadjuvant therapy (TNT) with standard therapy for locally advanced rectal cancer. It aims to determine if TNT is more effective and safer for patients.
Area of Science:
- Oncology
- Gastroenterology
- Clinical Trials
Background:
- Locally advanced rectal cancer (LARC) requires effective treatment strategies.
- Standard therapy often involves sequential chemoradiotherapy and surgery.
- Total neoadjuvant therapy (TNT) is an emerging approach integrating neoadjuvant treatments before surgery.
Purpose of the Study:
- To evaluate the effectiveness of total neoadjuvant therapy (TNT) compared to standard therapy for LARC.
- To assess the safety and tolerability of TNT in LARC patients.
- To synthesize evidence from Cochrane Reviews on neoadjuvant treatment protocols for rectal cancer.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Search of Cochrane Central Register of Controlled Trials (CENTRAL) and other databases.
- Assessment of oncological outcomes (e.g., survival, recurrence) and adverse events.
Main Results:
- Evidence synthesis on the comparative effectiveness of TNT versus standard therapy.
- Identification of potential benefits and harms associated with TNT.
- Analysis of patient-reported outcomes and quality of life.
Conclusions:
- The review will provide evidence-based conclusions on the role of TNT in LARC management.
- Findings will inform clinical decision-making regarding neoadjuvant treatment strategies.
- Future research directions will be identified based on the synthesized evidence.
