講演情報
[ESY1-1]Total Neoadjuvant Therapy and Non-operative Management for Rectal Cancer in the U.S.
Tsuyoshi Konishi (The University of Texas MD Anderson Cancer Center)
Total neoadjuvant therapy (TNT) is a novel strategy for rectal cancer that administers both (chemo)radiotherapy and systemic chemotherapy before surgery. TNT is expected to improve treatment compliance, tumor regression, and oncologic outcomes. Most importantly, TNT significantly improves a rate of clinical complete response and subsequent non-operative management. In the U.S., multiple TNT regimens are currently available with various combinations of the treatments including induction or consolidation chemotherapy, triplet or doublet chemotherapy, and long-course chemoradiotherapy or short-course radiotherapy. Evidence on TNT is rapidly evolving on clinical trials, and no definitive consensus has been established on which regimens to use. Multidisciplinary decision making needs consideration of the advantages and limitations in each TNE regimen. This lecture reviews currently available evidence on TNT for rectal cancer and provided a guide for tailor-made use of TNT regimens, particularly focusing on non-operative management.