Evidence map›Paper›PMID 39452500›Full record

ArticleDiseases (Basel, Switzerland)2024

Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Insights from the Western Australian Context.

Oliver Oey, Chak Pan Lin, Muhammad Adnan Khattak, Thomas Ferguson, Mary Theophilus, Siaw Sze Tiong, Sayed Ali, Yasir Khan

Abstract read
In one paragraph

Article in Diseases (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Oliver OeyUWA Medical School, University of Western Australia, Perth, WA 6009, Australia.
Chak Pan LinMater Hospital, Brisbane, QLD 4101, Australia.
Muhammad Adnan KhattakDepartment of Medical Oncology, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.
Thomas FergusonDepartment of Medical Oncology, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.
Mary TheophilusDepartment of General Surgery, St John of God Midland Hospital, Midland, WA 6056, Australia.
Siaw Sze TiongIcon Cancer Centre, Midland, WA 6056, Australia.
Sayed AliDepartment of Medical Oncology, St John of God Midland Hospital, Midland, WA 6056, Australia.
Yasir KhanDepartment of Medical Oncology, St John of God Midland Hospital, Midland, WA 6056, Australia.ORCID 0000-0001-5100-0287

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent studies have associated total neoadjuvant therapy (TNT) with better treatment adherence, decreased toxicity, improved complete clinical response and anal sphincter preservation rates in patients with locally advanced rectal cancer (LARC). However, real-world experience with TNT in the management of LARC remains limited.

aimThis study aimed to evaluate the efficacy and safety outcomes of TNT for LARC in Western Australia.

methodsPatients with LARC (cT2-4 and/or cN1-2) who underwent induction chemotherapy followed by neoadjuvant chemoradiotherapy or neoadjuvant chemoradiotherapy followed by consolidation chemotherapy, followed by surgery were recruited from two hospitals in Western Australia. Efficacy outcomes assessed included clinical response (complete, partial, no response), and pathologic complete response (pCR) rate, R0 resection rate, and R1 resection rate were evaluated. Those patients who achieved clinical complete response following TNT were given the option of active surveillance. The safety and tolerability of TNT were assessed.

results32 patients with LARC were treated with TNT. In total, 17 patients (53%) received chemoradiotherapy followed by consolidation chemotherapy and 15 patients (47%) received induction chemotherapy followed by chemoradiotherapy. Nine (28%) of the patients with LARC treated with TNT had a complete clinical response, twenty-one (66%) patients had a partial clinical response, and two (6%) patients had no response to TNT. Of the 32 patients, 27 (84%) underwent surgery. There was a 100% R0 resection rate. The pCR rate was 15%. pCR, clinical response, and the R0 resection rate were similar between the two TNT regimens. TNT was well tolerated, with the majority of patients (88%) completing the chemotherapy course with grade 1 and 2 adverse effects.

conclusionsIn conclusion, TNT emerges as a promising approach for the management of LARC. However, further research is warranted to refine the optimal TNT protocols, determine its long-term outcomes, and identify patient populations who would benefit the most from this innovative therapeutic strategy.

Indexed as

cancer treatmentchemoradiotherapychemotherapyLARClocally advanced rectal cancerradiotherapyTNTtotal neoadjuvant therapy

Identifiers

PMID39452500
PMCPMC11507632

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