BACKGROUND AND OBJECTIVES the total neoadjuvant chemoradiotherapy (TNT) includes different strategies, but the most appropriate model remains uncertain. The purpose of this retrospectively study was to evaluate the safety and pathological response in the consolidation chemotherapy model. METHODS patients with cT3/T4 or TxN + M0 rectal cancer that were receiving neoadjuvant chemoradiotherapy (CRT) (50 Gy with oral capecitabine)/TNT (CRT followed by three cycles of CAPOX) during September 2017 to September 2019 in our department were included. All of the patients were recommended to receive radical surgery. RESULTS a total of 197 patients were included. Eighty-one patients received CRT, while one hundred and sixteen patients received TNT. Nine patients did not undergo surgery because of the distant metastases (one patient (1.2%) in CRT group, two patients (1.7%) in TNT group) or a refusal of resection (two patients in CRT group, four patients in TNT group). The pathological complete response (pCR) rate was 32.7% in TNT compared with 12.8% in CRT (p = 0.002). There was no statistically significant difference in grade 3 acute toxicities of neoadjuvant treatment and surgical complications between the two groups. CONCLUSIONS the consolidation chemotherapy model is safe for patients with locally advanced rectal cancer and it has a high pCR rate. The long-term follow-up is necessary to be evaluated in a future prospective, randomized trial.

中文翻译：

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新辅助放化疗后增加三个周期的 CAPOX 可提高局部晚期直肠癌的完全缓解率

背景和目标 全新辅助放化疗 (TNT) 包括不同的策略，但最合适的模型仍然不确定。本回顾性研究的目的是评估巩固化疗模型的安全性和病理反应。方法 2017 年 9 月至 2019 年 9 月我科接受新辅助放化疗（CRT）（50 Gy 口服卡培他滨）/TNT（CRT 加 3 个周期 CAPOX）的 cT3/T4 或 TxN+M0 直肠癌患者纳入研究。所有患者均被推荐接受根治性手术。结果共纳入197名患者。81 名患者接受了 CRT，而 116 名患者接受了 TNT。CRT 组 9 名患者因远处转移未接受手术（1 名患者（1.2%），TNT 组 2 例（1.7%）或拒绝切除（CRT 组 2 例，TNT 组 4 例）。TNT 的病理完全缓解 (pCR) 率为 32.7%，而 CRT 为 12.8% (p = 0.002)。两组间新辅助治疗的 3 级急性毒性和手术并发症无统计学差异。结论 巩固化疗模式对局部晚期直肠癌患者安全且pCR率高。长期随访有必要在未来的前瞻性随机试验中进行评估。两组间新辅助治疗的 3 级急性毒性和手术并发症无统计学差异。结论 巩固化疗模式对局部晚期直肠癌患者安全且pCR率高。长期随访有必要在未来的前瞻性随机试验中进行评估。两组间新辅助治疗的 3 级急性毒性和手术并发症无统计学差异。结论 巩固化疗模式对局部晚期直肠癌患者安全且pCR率高。长期随访有必要在未来的前瞻性随机试验中进行评估。