Comparing early surgical outcomes between total neoadjuvant therapy and standard long course chemoradiotherapy for rectal cancer

Figure 1 Treatment Algorithm. A total of 99 patients were included in the study between October 2014 and November 2024; 29 patients underwent total neoadjuvant therapy with Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation (TNT-RAPIDO). The TNT-RAPIDO protocol consisted of short-course radiotherapy (five fractions of 5 Gy radiotherapy) followed by six cycles of oral capecitabine and intravenous oxaliplatin doublet consolidation chemotherapy. A total of 70 patients received long course chemoradiotherapy with 25 fractions of 45-50 Gy radiotherapy and concurrent chemotherapy with oral capecitabine or 5-fluorouracil. Laparoscopic or robot-assisted laparoscopic total mesorectal excision was subsequently performed. TNT: Total neoadjuvant therapy; RAPIDO: Rectal cancer and preoperative induction therapy followed by dedicated operation; CAPOX: Capecitabine and oxaliplatin; FOLFOX: Folinic acid, fluorouracil, and oxaliplatin; TME: Total mesorectal excision; RAL: Robotic assisted laparoscopic.