Case Reports

Total Neoadjuvant Therapy In Locally Advanced Rectal Cancer: A New Approach

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Ana Pissarra
Joana Luis
Daniela Macedo
Pedro Chinita
Nuno Figueiredo
Neodjuvant Therapy, Neoplasm Staging, Rectal Neoplasm/therapy, Watchful Waiting


Locally advanced rectal cancer (LARC) is a relatively common disease, with a poor prognosis because of its high metastatic potential.

Gold standard in the treatment for LARC includes concurrent chemoradiotherapy (CRT) followed by surgery and adjuvant chemotherapy. An alternative strategy known as total neoadjuvant therapy (TNT) involves administration of CRT plus neoadjuvant chemotherapy before surgery with the goal of delivering uninterrupted systemic therapy to eradicate micrometastasis.

Recent data suggests that TNT delivers superior rates of pathologic complete responses with similar disease-free and overall survival, compared to standard approach. Additionally, it may allow an increased number of patients entering organ preservation programs.

In light of a clinical case, the authors review this controversial but very contemporary issue.

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