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Total neoadjuvant therapy for rectal cancer: a guide for surgeons

The modern management of rectal cancers continues to evolve. With the release of data from new landmark randomized controlled trials (RAPIDO, PRODIGE-23), total neoadjuvant therapy (TNT) has moved to the forefront of locally advanced rectal cancer treatment and is considered a standard option in sel...

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Autores principales: Johnson, Garrett G.R.J., Park, Jason, Helewa, Ramzi M., Goldenberg, Benjamin A., Nashed, Maged, Hyun, Eric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CMA Impact Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125160/
https://www.ncbi.nlm.nih.gov/pubmed/37085291
http://dx.doi.org/10.1503/cjs.005822
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author Johnson, Garrett G.R.J.
Park, Jason
Helewa, Ramzi M.
Goldenberg, Benjamin A.
Nashed, Maged
Hyun, Eric
author_facet Johnson, Garrett G.R.J.
Park, Jason
Helewa, Ramzi M.
Goldenberg, Benjamin A.
Nashed, Maged
Hyun, Eric
author_sort Johnson, Garrett G.R.J.
collection PubMed
description The modern management of rectal cancers continues to evolve. With the release of data from new landmark randomized controlled trials (RAPIDO, PRODIGE-23), total neoadjuvant therapy (TNT) has moved to the forefront of locally advanced rectal cancer treatment and is considered a standard option in selected patients. Total neoadjuvant therapy promises enhanced systemic disease control, better treatment adherence and less time with an ostomy. However, TNT as currently described encompasses a number of different potential treatment options that differ significantly in terms of their radiation dosage, chemotherapy regimen and order of treatments administered. Being familiar with TNT regimens will be important for rectal cancer surgeons to appropriately advocate for their patients and optimize their outcomes. This article serves as a primer for the general surgeon and offers a pragmatic overview of the indications, realistic expected benefits and potential downsides of each TNT regimen.
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spelling pubmed-101251602023-04-25 Total neoadjuvant therapy for rectal cancer: a guide for surgeons Johnson, Garrett G.R.J. Park, Jason Helewa, Ramzi M. Goldenberg, Benjamin A. Nashed, Maged Hyun, Eric Can J Surg Discussions in Surgery The modern management of rectal cancers continues to evolve. With the release of data from new landmark randomized controlled trials (RAPIDO, PRODIGE-23), total neoadjuvant therapy (TNT) has moved to the forefront of locally advanced rectal cancer treatment and is considered a standard option in selected patients. Total neoadjuvant therapy promises enhanced systemic disease control, better treatment adherence and less time with an ostomy. However, TNT as currently described encompasses a number of different potential treatment options that differ significantly in terms of their radiation dosage, chemotherapy regimen and order of treatments administered. Being familiar with TNT regimens will be important for rectal cancer surgeons to appropriately advocate for their patients and optimize their outcomes. This article serves as a primer for the general surgeon and offers a pragmatic overview of the indications, realistic expected benefits and potential downsides of each TNT regimen. CMA Impact Inc. 2023-04-21 /pmc/articles/PMC10125160/ /pubmed/37085291 http://dx.doi.org/10.1503/cjs.005822 Text en © 2023 CMA Impact Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Discussions in Surgery
Johnson, Garrett G.R.J.
Park, Jason
Helewa, Ramzi M.
Goldenberg, Benjamin A.
Nashed, Maged
Hyun, Eric
Total neoadjuvant therapy for rectal cancer: a guide for surgeons
title Total neoadjuvant therapy for rectal cancer: a guide for surgeons
title_full Total neoadjuvant therapy for rectal cancer: a guide for surgeons
title_fullStr Total neoadjuvant therapy for rectal cancer: a guide for surgeons
title_full_unstemmed Total neoadjuvant therapy for rectal cancer: a guide for surgeons
title_short Total neoadjuvant therapy for rectal cancer: a guide for surgeons
title_sort total neoadjuvant therapy for rectal cancer: a guide for surgeons
topic Discussions in Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125160/
https://www.ncbi.nlm.nih.gov/pubmed/37085291
http://dx.doi.org/10.1503/cjs.005822
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