How We Treat Localized Rectal Cancer-An Institutional Paradigm for Total Neoadjuvant Therapy.
CRT
TNT
chemoradiotherapy
microsatellite instability
mismatch-repair-deficiency
organ-sparing
radiotherapy
rectal cancer
total neoadjuvant therapy
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
21 Nov 2022
21 Nov 2022
Historique:
received:
13
10
2022
revised:
15
11
2022
accepted:
16
11
2022
entrez:
26
11
2022
pubmed:
27
11
2022
medline:
27
11
2022
Statut:
epublish
Résumé
Total neoadjuvant therapy (TNT)-the neoadjuvant employment of radiotherapy (RT) or chemoradiation (CRT) as well as chemotherapy (CHT) before surgery-may lead to increased pathological complete response (pCR) rates as well as a reduction in the risk of distant metastases in locally advanced rectal cancer. Furthermore, increased response rates may allow organ-sparing strategies in a growing number of patients with low rectal cancer and upfront immunotherapy has shown very promising early results in patients with microsatellite instability (MSI)-high/mismatch-repair-deficient (dMMR) tumors. Despite the lack of a generally accepted treatment standard, we strongly believe that existing data is sufficient to adopt the concept of TNT and immunotherapy in clinical practice. The treatment algorithm presented in the following is based on our interpretation of the current data and should serve as a practical guide for treating physicians-without any claim to general validity.
Identifiants
pubmed: 36428801
pii: cancers14225709
doi: 10.3390/cancers14225709
pmc: PMC9688120
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
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