PRELIMINARY RESULTS OF TOTAL NEOADJUVANT THERAPY IN STAGE II–III RECTAL CANCER: REAL-WORLD DATA FROM K HOSPITAL

Tóm tắt

Background: Total Neoadjuvant Therapy (TNT) has recently emerged as a promising approach in the management of locally advanced rectal cancer. However, real-world evidence on its effectiveness and safety in Vietnam remains limited. Methods: We retrospectively analyzed 148 patients with stage II–III rectal cancer of the middle or lower rectum treated with TNT at K Hospital. TNT regimens included chemotherapy combined with either short-course or long-course chemoradiation therapy. Surgery was performed 4–8 weeks after completion of TNT. Treatment outcomes, pathological response, sphincter preservation, and adverse events were assessed. Results: The mean age was 57.2 years, with a male-to-female ratio of 1.96:1. Tumor downstaging was achieved in 68.9% of patients with a pathological complete response (pCR) rate of 25.7% and sphincter preservation rate of 71.6%. Peripheral neuropathy and elevated AST were the most common adverse events. Grade 3–4 toxicities most frequently included neutropenia (8.1%) and diarrhea (4.1%). Multivariate analysis revealed that earlier tumor stage and the use of triplet chemotherapy regimens were significantly associated with higher pCR rates. Conclusions: Total neoadjuvant therapy (TNT) was well tolerated in this cohort and was associated with favorable pathological response in patients with stage II–III rectal cancer. Further prospective studies are warranted to confirm these findings and optimize treatment strategies in the Vietnamese setting.