Key clinical point: Total neoadjuvant therapy (TNT) vs neoadjuvant chemoradiotherapy (nCRT) was associated with improved pathological complete response (pCR), R0 resection, disease-free survival (DFS), and overall survival (OS) in patients with locally advanced rectal cancer (LARC) along with similar postoperative complications and no increase in distant metastasis and local recurrence.
Major finding: TNT vs nCRT was associated with higher rates of pCR (odds ratio [OR] 1.85; P < .0001), longer DFS (hazard ratio [HR] 0.80; P = .001), longer OS (HR 0.75; P = .002), a higher proportion of patients achieving R0 resection (OR 1.34; P = .02), and similar rates of chemoradiotherapy and surgical complications, with no increase in local recurrence or distant metastasis.
Study details : This meta-analysis of eight non-randomized and seven randomized controlled trials included 3579 patients, of which 1812 patients received TNT and 1767 received nCRT.
Disclosures: This study was funded by the Natural Science Foundation of Gansu Province, China, and other sources. No conflicts of interest were declared.
Source: Zhang X et al. Total neoadjuvant therapy versus standard therapy in locally advanced rectal cancer: A systematic review and meta-analysis of 15 trials. PLoS One. 2022;17(11):e0276599 (Nov 4). Doi: 10.1371/journal.pone.0276599