Early response-adapted TNT preserved the rectum in a minority of selected patients
Two-year sustained complete response was 36% after short-course RT and response-adapted FOLFOX4, while near-complete responses frequently regrew.
Tag
rectal
Immune-rich rectal tumors responded better to neoadjuvant radiotherapy than stromal-rich tumors
Responsive rectal tumors showed greater cytotoxic immune infiltration, while poor responders were enriched for stromal, EMT and oncogenic pathways.
Short-course radiotherapy may be a stronger immunotherapy partner in rectal cancer
Recent trials report 40–61% pathologic complete response with short-course radiotherapy plus immunotherapy, but mature comparative outcomes remain unavailable.
Total neoadjuvant therapy is now central to high-risk rectal cancer and organ preservation
Total neoadjuvant therapy is now central to high-risk rectal cancer and organ preservation
Bowel dose predicted acute diarrhea after both RAPIDO neoadjuvant strategies
Larger irradiated bowel volumes predicted acute diarrhea after both short-course total neoadjuvant treatment and chemoradiation, although discrimination was modest.
THUNDER-2 used early tumor regression to guide adaptive rectal cancer dose escalation
ERI-guided escalation to 60.1 Gy produced a 21.9% complete response rate in patients predicted to respond poorly.
Pelvic bone marrow dose predicted hematologic toxicity during rectal chemoradiotherapy
Mean pelvic marrow dose above approximately 24 Gy and V40 above 13% identified higher hematologic toxicity risk during rectal chemoradiotherapy.
Short-course total neoadjuvant therapy improved five-year survival in STELLAR
Five-year overall survival was 78.1% with short-course total neoadjuvant therapy versus 69.7% with long-course chemoradiotherapy.
Immunotherapy-based TNT eliminated nodal disease in ypT0–1 rectal tumours
No positive lymph nodes were found in ypT0–1 tumours after immunotherapy-based TNT, supporting further study of local excision.
Oxaliplatin-based total neoadjuvant therapy improved three-year DFS in high-risk rectal cancer
Doublet total neoadjuvant therapy improved three-year disease-free survival, metastasis-free survival, and pathological complete response compared with conventional chemoradiotherapy.
Multimodal models appear most promising for predicting rectal cancer pathological complete response
No individual clinical, imaging, blood, or molecular marker reliably predicted pathological complete response, while integrated multimodal models showed greater potential.
Planning-CT radiomics improved pretreatment prediction of poor rectal cancer response
Adding CTV radiomics increased internal AUROC from 0.507 to 0.754 for predicting poor response to rectal chemoradiotherapy.
Dose-escalated chemoradiotherapy improved nine-year survival in locally advanced rectal cancer
A 56 Gy simultaneous integrated boost improved nine-year survival and disease control compared with standard 50 Gy chemoradiotherapy.
T1 relaxation mapping identified complete rectal cancer response at six weeks
Quantitative T1 relaxation time distinguished complete from incomplete rectal cancer response six weeks after neoadjuvant treatment with an area under the curve of 0.94.
Higher-BED palliative radiotherapy improved symptoms in rectal cancer
BED >37.5 Gy improved symptomatic control, while 6-month local control remained 46% in frail, elderly, or metastatic rectal cancer.