26.11.2021 | ASO Perspectives
Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: PRODIGE 23 Trial
verfasst von:
Martin R. Weiser, MD
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 3/2022
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Excerpt
Trimodal therapy in the form of chemotherapy, radiotherapy, and surgery is standard for locally advanced rectal cancer (T3/4 and either N0 or node-positive) and provides excellent local control. The order in which the different components of treatment are administered has been the topic of many practice-changing studies. For example, a 2004 German trial
1 demonstrated that preoperative chemoradiotherapy is better tolerated than adjuvant chemoradiotherapy and that it effectively downsizes tumors and results in fewer local recurrences. This led to the standard treatment paradigm of chemoradiotherapy followed by total mesorectal excision and then systemic chemotherapy. An alternative to that approach is total neoadjuvant therapy (TNT), in which systemic chemotherapy is administered before surgery. Compared with the conventional approach, TNT is associated with delivery of greater proportions of planned therapy, a higher likelihood of downstaging, and an earlier exposure of potential micrometastases to chemotherapy.
2‐4 …
