Moawia Mohammed Ali Elhassan, Associate Professor at the University of Gezira and Consultant in Clinical and Radiation Oncology at Universal Hospital, Sudan, shared a post on LinkedIn:
“Does one size fit all in rectal cancer ?
A recent JCO article highlights the significant variability in treatment selection for low- and mid-rectal cancer across different countries and centers. This underscores the critical need for a tailored, case-by-case approach.
The authors propose that future studies should analyze mid- and low-rectal tumors as distinct entities, using an anatomic landmark of 1 cm above the anal ring to differentiate them.
Key recommendations include:
Mid-Rectal Tumors: Induction chemotherapy without RT should be considered to improve long-term functional outcomes if surgery is planned. If the goal is a non-surgical approach, INCT-CRT/CNCT-CRT is preferred.
Low-Rectal Tumors: NOM is the optimal strategy for patients committed to rigorous surveillance. To maximize cCR, TNT is preferred over CRT alone.
The authors call for Phase III RCTs to compare two specific TNT strategies: INCT-CRT versus CNCT-CRT, using standardized intervals for response assessment.”
Title: Disruptive Analysis of Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Clinical and Therapeutic Distinctions Between Low- and Mid-Rectal Cancers
Authors: Barbara Noiret, Rodrigo O. Perez, Thierry Conroy, Carl J. Brown, Deborah Schrag, Laura Fernandez, Jeremie H. Lefevre, Stephane Benoist, Philippe Rouanet, Julio Garcia-Aguilar, Quentin Denost
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