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New Treatments Before Surgery May Improve Outcomes in Rectal Cancer

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New Treatments Before Surgery May Improve Outcomes in Rectal Cancer

Doctors often give treatment before surgery for rectal cancer. This is called neoadjuvant therapy (NAT). It can include chemotherapy, radiation, or both. A new study looked at many clinical trials to see which type of treatment works best.

The study analyzed results from 19 trials with more than 7,000 patients. It compared different treatment plans. The standard approach has been chemoradiation (chemotherapy plus radiation). Researchers found that two newer methods, called total neoadjuvant therapy (TNT), may work better. TNT can be given in two ways: induction (before radiation) or consolidation (after radiation).

Patients receiving TNT had higher chances of having no cancer left when their tumor was removed. This is known as a pathological complete response (pCR). TNT also increased the chances of organ preservation, meaning some patients were able to avoid permanent stomas.

But TNT is not risk-free. Patients receiving induction TNT had more side effects compared to the standard approach. Another method, short course radiotherapy, was linked to higher risks of incomplete removal of the tumor, which can affect recovery.

The study suggests that TNT, especially consolidation TNT, offers new hope for patients with rectal cancer. It can improve surgery outcomes and may allow some patients to keep more normal bowel function. Still, side effects remain a concern, and patients should discuss with their doctors which treatment plan is safest and most effective for them.

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Dr. Harsh J Shah

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Dr Harsh Shah - GI & HPB Oncosurgeon in India
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