'Effective prior chemotherapy and radiation therapy prior to rectal cancer surgery'
Oct 22, 2024
Until now, rectal cancer close to the anus has been performed as a standard treatment method by performing surgery to remove cancer tumors and rectums after radiation therapy before surgery, making an artificial anus, and then performing additional chemotherapy.
However, there are problems that cause deterioration of quality of life due to artificial anus, severe changes in bowel habits such as fecal incontinence, and various side effects. Recently, a treatment strategy that preserves the rectum by performing both chemotherapy and radiation treatment before surgery, 'T; Total Neoadjuvant Therapy (TNT)' is recommended as a new standard treatment, and the treatment effect is also better, according to a recent study.
Total Neoadjuvant Therapy (TNT)' is to perform both chemotherapy and radiation therapy before surgery, and has the advantage of having higher compliance with treatment and higher complete remission rates' compared to conventional preoperative radiation therapy.
In addition, patients with complete remission after 'total prior chemotherapy' can perform long-term preservation management that preserves the rectum itself rather than the existing anal preservation surgery, thereby avoiding problems such as fecal incontinence after artificial anus surgery.
In the meantime, Park Byung-kwan, a professor of colorectal surgery at the Cancer Center at Chung-Ang University Hospital (Hospital Director Kwon Jeong-taek), recently collaborated with a research team at the Memorial Sloan Kettering Cancer Center in the United States, the world's leading cancer hospital, on the effectiveness of anal preservation treatment in rectal cancer patients who received total prior chemotherapy and radiation therapy (Organ preservation after neoadjuvant long-course chemoradiotherapy), a global oncology journal.
The research team followed 323 patients who underwent all prior anticancer and radiation treatments before rectal cancer surgery from 2018 to 2021 and analyzed survival rates and anal preservation rates, and confirmed that about 81% of 142 patients who showed complete remission without remaining tumors preserved anus and rectum.
Among them, rectal cancer patients who underwent long-course chemotherapy (LCCRT) showed an anal retention rate of 84% and short-course radiotherapy (SCRT) patients who underwent short-course radiotherapy (SCRT) showed an anal retention rate of 70%.
As a result, the research team confirmed for the first time that long-term chemotherapy and radiation therapy before surgery are effective in preserving the anus and survival rates in the treatment of rectal cancer.
Park Byung-kwan, professor of colorectal surgery at Chung-Ang University Hospital's Cancer Center, said "We hope that this study will change the paradigm in the treatment of rectal cancer and help improve patients' treatment by applying the 'whole leading anticancer and radiation therapy' as a standard treatment method."In fact, in Korea, it is expected that the entire 'priority anticancer and radiation therapy' can be actively implemented as it is also included in the coverage of the Health Insurance Review and Assessment Service's benefits from October 2024."
Professor Park Byung-kwan then explained, `Although the complete remission rate and long-term preservation rate after the entire prior treatment are clearly higher than those of the existing treatment, it should be conducted more carefully as there is not yet sufficient evidence to predict clinical complete remission and how to conduct follow-up tests in long-term preservation patients"This should be done with the careful judgment and sufficient understanding of experts based on multiple tests, not for all patients," he stressed.
However, there are problems that cause deterioration of quality of life due to artificial anus, severe changes in bowel habits such as fecal incontinence, and various side effects. Recently, a treatment strategy that preserves the rectum by performing both chemotherapy and radiation treatment before surgery, 'T; Total Neoadjuvant Therapy (TNT)' is recommended as a new standard treatment, and the treatment effect is also better, according to a recent study.
Total Neoadjuvant Therapy (TNT)' is to perform both chemotherapy and radiation therapy before surgery, and has the advantage of having higher compliance with treatment and higher complete remission rates' compared to conventional preoperative radiation therapy.
In addition, patients with complete remission after 'total prior chemotherapy' can perform long-term preservation management that preserves the rectum itself rather than the existing anal preservation surgery, thereby avoiding problems such as fecal incontinence after artificial anus surgery.
In the meantime, Park Byung-kwan, a professor of colorectal surgery at the Cancer Center at Chung-Ang University Hospital (Hospital Director Kwon Jeong-taek), recently collaborated with a research team at the Memorial Sloan Kettering Cancer Center in the United States, the world's leading cancer hospital, on the effectiveness of anal preservation treatment in rectal cancer patients who received total prior chemotherapy and radiation therapy (Organ preservation after neoadjuvant long-course chemoradiotherapy), a global oncology journal.
The research team followed 323 patients who underwent all prior anticancer and radiation treatments before rectal cancer surgery from 2018 to 2021 and analyzed survival rates and anal preservation rates, and confirmed that about 81% of 142 patients who showed complete remission without remaining tumors preserved anus and rectum.
Among them, rectal cancer patients who underwent long-course chemotherapy (LCCRT) showed an anal retention rate of 84% and short-course radiotherapy (SCRT) patients who underwent short-course radiotherapy (SCRT) showed an anal retention rate of 70%.
As a result, the research team confirmed for the first time that long-term chemotherapy and radiation therapy before surgery are effective in preserving the anus and survival rates in the treatment of rectal cancer.
Park Byung-kwan, professor of colorectal surgery at Chung-Ang University Hospital's Cancer Center, said "We hope that this study will change the paradigm in the treatment of rectal cancer and help improve patients' treatment by applying the 'whole leading anticancer and radiation therapy' as a standard treatment method."In fact, in Korea, it is expected that the entire 'priority anticancer and radiation therapy' can be actively implemented as it is also included in the coverage of the Health Insurance Review and Assessment Service's benefits from October 2024."
Professor Park Byung-kwan then explained, `Although the complete remission rate and long-term preservation rate after the entire prior treatment are clearly higher than those of the existing treatment, it should be conducted more carefully as there is not yet sufficient evidence to predict clinical complete remission and how to conduct follow-up tests in long-term preservation patients"This should be done with the careful judgment and sufficient understanding of experts based on multiple tests, not for all patients," he stressed.
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