ArticleEClinicalMedicine2024
Total neoadjuvant treatment using short-course radiotherapy and four CAPOX cycles in locally advanced rectal cancer with high-risk criteria for recurrence: a Swedish nationwide cohort study (LARCT-US).
Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Watch-and-Wait strategy for locally advanced rectal cancer after neoadjuvant chemoradiotherapy: a comprehensive review.Frontiers in oncology · 2026Pooled it
- Total neoadjuvant therapy based on short-course radiotherapy versus standard long-course chemoradiotherapy for locally advanced rectal cancer: a systematic review and meta-analysis of randomized controlled trials.Frontiers in oncology · 2024Pooled it
- Minimum 18-week chemotherapy improves survival in locally advanced rectal cancer after neoadjuvant radiotherapy: a post hoc analysis of the STELLAR trial.BMC medicine · 2026Trial
- Total neoadjuvant therapy for rectal cancer: where are we now, where do we go?Clinical and translational radiation oncology · 2026Review
- Article
- Total Neoadjuvant Therapy, Organ Preservation and Beyond: A State-of-the-Art Systematic Review and Critical Appraisal of Locally Advanced Rectal Cancer Management.Diseases (Basel, Switzerland) · 2026Review
- Risk of late recurrence of colorectal and breast cancer among older long-term cancer survivors.JNCI cancer spectrum · 2026Article
- Locoregional and systemic control after total neoadjuvant therapy with short-course radiotherapy for locally advanced rectal cancer: long-term outcomes from the LARCT-US study.The British journal of surgery · 2026Observational
- Inclusion of tumor periphery in radiomics analysis of magnetic resonance images does not improve predictions of preoperative therapy response in patients with rectal cancer.Abdominal radiology (New York) · 2026Article
- Article
- Article
- Neoadjuvant Radiochemotherapy and Total Neoadjuvant Therapy in the Management of Locally Advanced Rectal Cancer.Cureus · 2025Article
- An In Silico Feasibility Study of Dose-Escalated Hypofractionated Proton Therapy for Rectal Cancer.Cancers · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Total neoadjuvant treatment (TNT) for locally advanced rectal cancer (LARC) increases pathologic complete response (pCR) rate and reduces the risk of systemic recurrences over chemoradiotherapy (CRT) in randomised trials, e.g., the RAPIDO trial. A modified RAPIDO schedule was prospectively explored in Sweden to evaluate TNT in routine health care before the RAPIDO results were published. Methods: Between July 2016 and June 2020, 273 patients with high-risk LARC (clinical tumour stage cT4, clinical nodal stage cN2, extramural vascular invasion, involved mesorectal fascia or enlarged lateral lymph nodes) were treated in a prospective observational cohort study at 16 hospitals (LARCT-US). Another 189 patients at 18 (including the 16) hospitals were similarly treated ( Findings: Compared to the RAPIDO trial, patients were older, and tumours more advanced. Median follow-up was 4.8 years (IQR 4.2-5.2). In LARCT-US all patients received radiotherapy and 268 (98%) started chemotherapy whereas in AdmL all patients received radiotherapy and chemotherapy. In LARCT-US 34 patients had pCR and 31 sustained cCR resulting in a CR-rate of 24% (95% CI 20-28). In AdmL, results were similar (23%, 95% CI 17-30). Locoregional recurrences were 6% (95% CI 4-10) and 5% (95% CI 2-9), respectively, both at 3 years and at last follow-up. Neurotoxicity, recorded in LARCT-US, was lower than in RAPIDO (EORTC-QLQ-CIPN20 tingling toes or feet mean score 24 (SD 31) vs 43 (SD 37)). One treatment-associated death occurred. Interpretation: Despite older patients and more advanced tumours, results similar to the RAPIDO trial were obtained. Hence, two chemotherapy cycles less do not compromise the results maintaining a high CR-rate. This TNT schedule resulted in favourable outcomes in a nation-wide real-life situation. Funding: Swedish Cancer Society.
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