Total Neoadjuvant Therapy With Long-Course Radiotherapy Versus Chemoradiotherapy in High-Risk Locally Advanced Rectal Cancer (TNTCRT): A Multicenter, Randomized, Phase III Trial.
J Clin OncolJul 23, 2026 (epub)
Xin Wang, Yuanling Tang, Junyang Lu et al.
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In 30 seconds
This multicenter, randomized, phase III trial evaluated total neoadjuvant therapy (TNT) with long-course radiotherapy (LCRT) versus conventional neoadjuvant chemoradiotherapy (nCRT) in patients with high-risk locally advanced rectal cancer. Among 458 patients, doublet-LC TNT significantly improved 3-year disease-free survival (DFS) at 74.8% compared to 66.0% for nCRT (HR, 0.674; P = .016) at a median follow-up of 51 months.
Key findings
- 3-year DFS was 74.8% for doublet-LC TNT versus 66.0% for nCRT (HR, 0.674; P = .016).
- Metastasis-free survival was 77.7% for doublet-LC TNT compared to 67.6% for nCRT (HR, 0.655; P < .001).
- Pathologic complete response rates were 26.37% for doublet-LC TNT versus 9.80% for nCRT (P < .001).
- Grade ≥3 adverse events were more frequent with doublet-LC TNT (27.59% vs 8.56%; P < .001).
Why it matters
The study highlights the potential of doublet-LC TNT to enhance disease-free survival and metastasis-free survival in high-risk locally advanced rectal cancer, suggesting a shift in treatment paradigms that could improve patient outcomes.