ArticleFrontiers in oncology2024
A randomized phase 3 trial of total neoadjuvant therapy (induction chemotherapy, neoadjuvant chemoradiation, neoadjuvant chemotherapy, and surgery) vs. standard long-term chemoradiation therapy (neoadjuvant chemoradiation, surgery, and adjuvant chemotherapy) in locally advanced rectal cancer.
Article in Frontiers in oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Prioritizing Chemotherapy in Total Neoadjuvant Therapy Improves pCR Rate in Locally Advanced Rectal Cancer in Countries with Limited Radiotherapy Access: A Randomized Controlled Trial.Journal of gastrointestinal cancer · 2026Trial
- Case Report: Endoscopic resection of giant colonic pedunculated polyps in patients with AIDS using a novel nylon rope and titanium clip technique.Frontiers in oncology · 2025Article
- Surgical outcomes and prognostic factors of neoadjuvant chemotherapy followed by interval debulking surgery in advanced ovarian cancer.American journal of cancer research · 2025Article
- Total Neoadjuvant Therapy Versus Conventional Neoadjuvant Therapy for Rectal Cancer: Cost Analysis in a Public Healthcare System.ANZ journal of surgeryArticle
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Abstract
Purpose: The management of rectal adenocarcinoma has evolved during the last decade, shifting from a conventional neoadjuvant chemoradiotherapy, surgery, and adjuvant chemotherapy in all cases to a total neoadjuvant approach, especially in locally advanced tumors when a sphincter-sparing surgery has been planned. However, the exact indications and the neoadjuvant regimen with the highest response remain unresolved. We aimed to assess whether administering neoadjuvant chemotherapy before and after preoperative chemoradiotherapy could increase the pathological complete response (pCR) rates. Methods: We conducted a phase 3, multicenter, randomized trial at four hospitals in Iran. Adult patients with a newly diagnosed, biopsy-proven, locally advanced non-metastatic rectal adenocarcinoma with an ECOG performance status of 0-2 were randomly assigned (2:2) to either the total neoadjuvant treatment (TNT) or the standard-of-care groups using a block randomized design. Investigators and participants were not masked to treatment allocation and groups. The TNT group received neoadjuvant chemotherapy with FOLFOX6 (intravenous 85 mg/m Results: Overall, 25 and 27 patients were enrolled in the TNT and standard-of-care groups, respectively. Both groups were similar in terms of gender, age, and tumor differentiation. The tumors in the standard-of-care group were significantly located closer to the anal verge compared with those in the TNT group (9.4 ± 3.7 cm in TNT vs. 6.8 ± 4 cm in standard, Conclusion: Our results showed that TNT is a safe and feasible treatment approach in patients with rectal cancer and may improve the overall pCR rate compared with standard treatment. Clinical trial registration: https://irct.behdasht.gov.ir/trial/65666, identifier IRCT20220723055527N1.
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