Total neoadjuvant therapy (TNT) is a novel strategy for rectal cancer that administers both (chemo)radiotherapy and systemic chemotherapy before surgery. TNT is expected to improve treatment compliance, tumor regression, organ preservation, and oncologic outcomes. Multiple TNT regimens are currently available with various combinations of the treatments including induction or consolidation chemotherapy, triplet or doublet chemotherapy, and long-course chemoradiotherapy or short-course radiotherapy. Evidence on TNT is rapidly evolving with new data on clinical trials, and no definitive consensus has been established on which regimens to use for improving outcomes. Clinicians need to understand the advantages and limitations of the available regimens for multidisciplinary decision making. This article reviews currently available evidence on TNT for rectal cancer. A decision making flow chart is provided for tailor-made use of TNT regimens based on tumor location and local and systemic risk.
全疗程新辅助治疗（TNT）是一种针对直肠癌的新型治疗策略，即在手术前同时进行（化学）放射治疗和全身化疗。TNT有望提高治疗依从性、促进肿瘤消退、实现器官保留并改善肿瘤学预后。目前存在多种TNT方案，包括诱导或巩固化疗、三联或双联化疗、长程放化疗或短程放疗等不同治疗组合。随着临床试验新数据的不断涌现，关于TNT的证据正在快速发展，但关于何种方案能改善预后尚未形成明确共识。临床医生需要了解现有方案的优势与局限性，以便进行多学科决策。本文综述了目前关于直肠癌TNT的现有证据，并基于肿瘤位置、局部及全身风险因素，提供了个体化应用TNT方案的决策流程图。
Total Neoadjuvant Therapy for Rectal Cancer: Which Regimens to Use?
肿瘤(癌症)患者之家