ReviewCancer medicine2024
Optimal Sequence for Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: An Evidence-Based Review.
Review in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Immune checkpoint inhibitors with neoadjuvant chemoradiotherapy in proficient MMR rectal cancer: systematic review and meta-analysis.Radiation oncology (London, England) · 2026Pooled it
- Short-course versus long-course neoadjuvant chemoradiotherapy in patients with rectal cancer: long-term results of a randomized controlled trial.International journal of colorectal disease · 2025Trial
- Four-Year Survival Outcomes of Personalized Total Neoadjuvant Therapy Versus Chemotherapy During the 'Wait Period' Versus Standard Chemoradiotherapy for Locally Advanced Rectal Cancer.Journal of gastrointestinal cancer · 2026Article
- Effect of dose escalation in neoadjuvant chemoradiotherapy of locally advanced rectal cancer on clinical and pathologic Response: A Systematic review andClinical and translational radiation oncology · 2026Review
- Predictors of survival for locally advanced rectal cancer patients with poor response to neoadjuvant chemoradiotherapy.Radiation oncology (London, England) · 2026Article
- Body Composition and Survival in Locally Advanced Rectal Cancer Patients Treated with Neoadjuvant Radiochemotherapy.Nutrients · 2025Article
- CD8-positive lymphocyte infiltration as a marker of anti-tumor immune response in rectal cancer: pre- and post-neoadjuvant radiotherapy comparison.Clinical and translational radiation oncology · 2025Article
- Article
- The role of radiotherapy in the management of metastatic rectal cancer: A narrative review on the opportunities for non-operative management and organ preservation.Clinical and translational radiation oncology · 2025Review
- Safety and Efficacy of Serplulimab Combined with Neoadjuvant Chemoradiotherapy in High-Risk Locally Advanced Rectal Cancer: A Retrospective Study.Cancer management and research · 2025Article
- Postoperative NEOadjuvant TEMozolomide followed by chemoradiotherapy versus upfront chemoradiotherapy for glioblastoma multiforme (NEOTEM) trial: Interim results.Neuro-oncology advancesArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHistorically, multimodal therapeutic strategies involving preoperative chemoradiotherapy (CRT), surgery, and adjuvant chemotherapy (CT) have been employed to treat locally advanced rectal cancer (LARC). Total Neoadjuvant Therapy (TNT) is showing promise in improving outcomes. Despite its benefits, the optimal sequencing within TNT-whether induction chemotherapy should precede or follow chemoradiotherapy-remains a critical question. This study endeavors to explore the effects of different TNT sequencing strategies on patient outcomes, including tumor downstaging, pathological response, organ preservation, and the balance between efficacy and tolerability.
methodsOur methodology entailed a comprehensive literature review conducted on Medline, focusing on recent research, including retrospective studies, systematic reviews, and clinical trials. The review emphasized the comparison of induction chemotherapy versus consolidation chemotherapy within TNT regimens, assessing outcomes such as pathological response, organ preservation rates, and adverse effects. To ensure the selection of appropriate and high-quality studies, specific inclusion and exclusion criteria were applied.
resultsThe analysis revealed that induction chemotherapy might lead to decreased adherence to subsequent chemoradiotherapy while offering an early intervention against micrometastasis and potentially improving overall chemotherapy compliance. Conversely, consolidation chemotherapy has been associated with higher pathological complete response (pCR) rates and improved tolerability, indicating its potential for patients requiring local symptom relief or those eligible for a nonoperative management approach. Comparative studies like CAO/ARO/AIO-12 and the OPRA trials have significantly contributed to our understanding, suggesting that while both strategies have distinct advantages, the choice between induction and consolidation chemotherapy should be tailored based on individual patient profiles and tumor characteristics.
conclusionThis narrative review underscores the importance of a nuanced approach to TNT sequencing in locally advanced rectal cancer, highlighting the need for further research to refine treatment strategies.
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