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Pathologic response after total neoadjuvant therapy in stage II-III rectal cancer: preliminary results from a
Vo Duc Hieu1, Phan Thi Hong Duc2, Nguyen Hoang Quy3
1Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam.
Introduction:
Total neoadjuvant therapy (TNT) is increasingly recommended for locally advanced rectal cancer (LARC), yet data from developing countries remain limited. In Vietnam, constraints in diagnostic access, radiotherapy availability, and multidisciplinary coordination may affect treatment feasibility and outcomes.
Objective:
To evaluate pathological response, safety, and perioperative outcomes of TNT for stage II-III rectal cancer in a Vietnamese oncology center.
Methods:
This prospective single-arm study enrolled 101 patients who received long-course chemoradiotherapy followed by consolidation capecitabine-oxaliplatin (CAPOX) or 5-fluorouracil/leucovorin-oxaliplatin (FOLFOX)before total mesorectal excision. Pathologic response and tumor regression grade were assessed.
Results:
Among 95 resected patients, pathological complete response (pCR) was 35.7%, and good regression (TRG 0-1) was achieved in 70.4%. Treatment completion was high (94.1%), with acceptable toxicity and no treatment-related mortality.
Conclusion:
TNT is feasible, safe, and achieves response outcomes comparable to global benchmarks, supporting its integration into rectal cancer management in resource-limited settings.
