Novel Rectal Cancer Treatment: Claims Less Risk of Reoccurence and Avoid Surgery, Study Finds

A new treatment for advanced rectal cancer (LARC) called Total neoadjuvant treatment (TNT) has resurfaced and has proved successful enough to avoid surgery and reduce the risk of recurrence, according to a new study published in eClinical Medicine.

Total neoadjuvant treatment (TNT) combines short-course radiotherapy with several rounds of chemotherapy. A study conducted in Sweden revealed that this approach was twice as effective in shrinking tumours compared to earlier methods. Additionally, this treatment has the potential to decrease the necessity for complex bowel surgeries and the associated complications.

For the study, researchers tracked 273 patients with high-risk locally advanced rectal cancer (LARC) across 16 hospitals from July 2016 to June 2020, and an additional 189 patients at 18 hospitals (including the original 16) during the same timeframe. All patients underwent total neoadjuvant treatment (TNT). The study revealed that the proportion of patients with tumour disappearance increased from 14% to 28% compared to earlier treatment regimens, with no rise in recurrence rates.

The usual treatment for rectal cancer often involves over a month of radiotherapy or a mix of radiotherapy and chemotherapy. Surgery usually means removing part of the bowel, which can lead to issues with bowel control and the need for a stoma. Researchers noted that the new total neoadjuvant treatment (TNT) can directly target tumors and might reduce the need for this invasive surgery and its side effects.

Reference: Glimelius, B., Khan, T., Adolfsson, K., Angenete, E., Berglund, Å., & Bondef, K. (2024). Total neoadjuvant treatment using short-course radiotherapy and four CAPOX cycles in locally advanced rectal cancer with high-risk criteria for recurrence: A Swedish nationwide cohort study (LARCT-US). eClinicalMedicine. https://doi.org/10.1016/j.eclinm.2024.102771