For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
2
views
19
references
 Top references
cited by
1
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      378
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Total neoadjuvant therapy for rectal cancer: evidence and challenge

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Recent advances in the management of rectal cancer have dramatically changed the clinical practice of colorectal surgeons because the main focus of rectal cancer treatment has changed from sphincter-saving to an organ-preserving strategies. Modifying the delivery of systemic chemotherapy to improve patients’ survival is another progress in colorectal cancer management, known as total neoadjuvant therapy (TNT). TNT is a new strategy used by colorectal surgeons to improve the quality of life and survival of patients after treatment. TNT poses limitations or obstacles, such as overtreatment issues in patients with stage I rectal cancer. However, considering the quality-of-life issues in patients with low-lying rectal cancer necessitating a permanent colostomy, the indication for TNT will be expanded. This review summarizes the recently conducted clinical trials and foresees future perspectives on TNT.

          Related collections

          Most cited references19

          • Record: found
          • Abstract: found
          • Article: not found

          Preoperative versus postoperative chemoradiotherapy for rectal cancer.

          Rolf Sauer, Heinz Becker, Werner Hohenberger … (2004)
          Postoperative chemoradiotherapy is the recommended standard therapy for patients with locally advanced rectal cancer. In recent years, encouraging results with preoperative radiotherapy have been reported. We compared preoperative chemoradiotherapy with postoperative chemoradiotherapy for locally advanced rectal cancer. We randomly assigned patients with clinical stage T3 or T4 or node-positive disease to receive either preoperative or postoperative chemoradiotherapy. The preoperative treatment consisted of 5040 cGy delivered in fractions of 180 cGy per day, five days per week, and fluorouracil, given in a 120-hour continuous intravenous infusion at a dose of 1000 mg per square meter of body-surface area per day during the first and fifth weeks of radiotherapy. Surgery was performed six weeks after the completion of chemoradiotherapy. One month after surgery, four five-day cycles of fluorouracil (500 mg per square meter per day) were given. Chemoradiotherapy was identical in the postoperative-treatment group, except for the delivery of a boost of 540 cGy. The primary end point was overall survival. Four hundred twenty-one patients were randomly assigned to receive preoperative chemoradiotherapy and 402 patients to receive postoperative chemoradiotherapy. The overall five-year survival rates were 76 percent and 74 percent, respectively (P=0.80). The five-year cumulative incidence of local relapse was 6 percent for patients assigned to preoperative chemoradiotherapy and 13 percent in the postoperative-treatment group (P=0.006). Grade 3 or 4 acute toxic effects occurred in 27 percent of the patients in the preoperative-treatment group, as compared with 40 percent of the patients in the postoperative-treatment group (P=0.001); the corresponding rates of long-term toxic effects were 14 percent and 24 percent, respectively (P=0.01). Preoperative chemoradiotherapy, as compared with postoperative chemoradiotherapy, improved local control and was associated with reduced toxicity but did not improve overall survival. Copyright 2004 Massachusetts Medical Society.
          Article 0 comments Cited 492 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial

            Renu Bahadoer, Esmée A Dijkstra, Boudewijn van Etten … (2020)
            Systemic relapses remain a major problem in locally advanced rectal cancer. Using short-course radiotherapy followed by chemotherapy and delayed surgery, the Rectal cancer And Preoperative Induction therapy followed by Dedicated Operation (RAPIDO) trial aimed to reduce distant metastases without compromising locoregional control.
            Article 0 comments Cited 327 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              PD-1 Blockade in Mismatch Repair–Deficient, Locally Advanced Rectal Cancer

              Andrea Cercek, Melissa Amy Lumish, Jenna Sinopoli … (2022)
              Article 0 comments Cited 309 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Coloproctol
                Journal ID (iso-abbrev): Ann Coloproctol
                Journal ID (publisher-id): AC
                Title: Annals of Coloproctology
                Publisher: Korean Society of Coloproctology
                ISSN (Print): 2287-9714
                ISSN (Electronic): 2287-9722
                Publication date (Print): August 2023
                Publication date (Electronic): 29 August 2023
                Volume: 39
                Issue: 4
                Pages: 301-306
                Affiliations
                Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
                Author notes
                Correspondence to: Suk-Hwan Lee, MD Department of Surgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea Email: leeshdr@ 123456khu.ac.kr
                Author information
                http://orcid.org/0000-0001-6470-8620
                Article
                Publisher ID: ac-2023-00269-0038
                DOI: 10.3393/ac.2023.00269.0038
                PMC ID: 10475808
                PubMed ID: 37648423
                SO-VID: a853e5a2-4218-48d4-ab23-61cc3dbc67ac
                Copyright © © 2023 Korean Society of Coloproctology
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 April 2023
                Date revision received : 28 June 2023
                Date accepted : 28 June 2023
                Categories
                Subject: Review
                Subject: Colorectal Cancer

                Keywords: rectal neoplasms,consolidation chemotherapy,induction chemotherapy,neoadjuvant therapy,total neoadjuvant therapy
                Data availability:
                Keywords: rectal neoplasms, consolidation chemotherapy, induction chemotherapy, neoadjuvant therapy, total neoadjuvant therapy

                Comments

                Comment on this article