SynthesisThe oncologist2021
Total Neoadjuvant Therapy (TNT) versus Standard Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis.
Synthesis in The oncologist, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 132 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neoadjuvant Chemoradiotherapy and Consolidation Chemotherapy for Rectal Cancer: A Randomized Controlled Trial
The Efficacy of Combination of Modulated Electro-Hyperthermia(mEHT) in The Multimodality Management in Locally Advanced Rectal Cancer: A Multicenter Phase 3 Randomized Control Trial.
Who cites it
132 citing papers in PubMed, 9 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- Immune checkpoint inhibitors with neoadjuvant chemoradiotherapy in proficient MMR rectal cancer: systematic review and meta-analysis.Radiation oncology (London, England) · 2026Pooled it
- Prognostic utility of perineural invasion in individuals with rectal cancer receiving neoadjuvant chemoradiotherapy: a meta-analysis.Frontiers in oncology · 2026Pooled it
- Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2024 for the treatment of colorectal cancer.International journal of clinical oncology · 2025Guideline
- Neoadjuvant therapy for colorectal cancer from 2015 to 2024: a visual analysis and bibliometric analysis.Frontiers in oncology · 2025Pooled it
- Effect of adjuvant chemotherapy on the oncological outcome of rectal cancer patients with pathological complete response.World journal of surgical oncology · 2024Pooled it
- The role of adjuvant chemotherapy in rectal cancer patients with ypT0-2N0 after neoadjuvant chemoradiotherapy.Frontiers in oncology · 2024Pooled it
- Efficacy and safety of total neoadjuvant therapy in locally advanced rectal cancer: a meta-analysis.International journal of colorectal disease · 2023Pooled it
- Microsatellite instability in rectal cancer: what does it mean? A study of two randomized trials and a systematic review of the literature.Histopathology · 2022Pooled it
- Pooled it
- Pilot Randomized Trial of a Supportive Care Intervention for Patients With Locally Advanced Rectal Cancer.Journal of pain and symptom management · 2026Trial
- The ILEOSTIM trial: A multicentre randomised controlled trial evaluating the impact of efferent loop stimulation prior to ileostomy reversal on postoperative ileus.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Trial
- Trial
- Is There any Benefit of Addition of Neo-Adjuvant Chemotherapy (FOLFOX4) to Standard Preoperative Treatment of Rectal Cancer? A Randomized Clinical Trial.Asian Pacific journal of cancer prevention : APJCP · 2024Trial
- Perioperative tislelizumab with four cycles of neoadjuvant chemotherapy for resectable locally advanced esophageal squamous cell carcinoma: a phase 2 study.Frontiers in immunology · 2024Trial
- Long-term results of a phase 2 study of neoadjuvant chemotherapy with molecularly targeted agents for locally advanced rectal cancer.International journal of clinical oncology · 2023Trial
- Short-Term Outcomes of Transanal Total Mesorectal Excision for Rectal Cancer: A Multicenter Propensity Score-Matched Analysis Comparing Patients With and Without Preoperative Neoadjuvant Therapy.Annals of gastroenterological surgery · 2026Article
- Early response of total neoadjuvant therapy with regional deep hyperthermia for low-lying locally advanced rectal cancer: a single-center retrospective study.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Prognostic and Diagnostic Significance of Annexin A1 in ypT3 Locally Advanced Rectal Cancer Patients.International journal of molecular sciences · 2026Article
- Total Neoadjuvant Therapy Versus Long-Course Chemoradiotherapy in Locally Advanced Rectal Cancer: Real-World Tumor Response and Clinical Outcomes.Medical sciences (Basel, Switzerland) · 2026Article
- Article
72 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTotal neoadjuvant therapy (TNT) is a novel approach for locally advanced rectal cancer (LARC), which attempts to deliver both systemic chemotherapy and neoadjuvant chemoradiotherapy prior to surgery. However, its efficacy and safety remain controversial in randomized controlled trials (RCTs). We conducted this meta-analysis to assess such concerns. MATERIALS AND
methodsHead-to-head phase II/III RCTs were searched in Embase, PubMed, Web of Science, and the Cochrane Library, as well as other sources. The primary endpoint was pathologic complete response (pCR). Secondary endpoints were disease-free survival (DFS), overall survival (OS), local recurrence-free survival, distant metastasis-free survival, and the R0 resection rate.
resultsEight phase II/III RCTs involving 2,196 patients with LARC were assessed. The primary analysis demonstrated a statistically significant improvement in the pCR rate for TNT treatment (odds ratio, 1.77; 95% confidence interval [CI], 1.28-2.45; p = .0005). TNT treatment also showed improvements in DFS and OS outcomes compared with standard chemoradiotherapy (hazard ratio [HR], 0.83; 95% CI, 0.72-0.96; p = .03 and HR, 0.88; 95% CI, 0.74-1.05; p = .15). In addition, TNT treatment showed significant efficacy in reducing the risk of distant metastasis (HR, 0.81; 95% CI, 0.68-0.95; p = .012).
conclusionThe overall pCR rate may be improved with TNT compared with standard treatment. The TNT strategy may also improve DFS and OS and reduce the risk of distant metastasis. IMPLICATIONS FOR PRACTICE: Locally advanced rectal cancer (LARC) is a relatively common disease, with a poor prognosis because of its high metastatic potential. The role of total neoadjuvant therapy (TNT) has always been controversial. This meta-analysis found that TNT in LARC is associated with a significant improvement in overall pathologic complete response rate, disease-free survival, overall survival, and distant metastasis-free survival compared with standard treatment. TNT is a promising strategy for LARC, especially for patients who have little desire for surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.