KẾT QUẢ BƯỚC ĐẦU VÀ KHẢ NĂNG DUNG NẠP CỦA PHÁC ĐỒ ĐIỀU TRỊ TÂN BỔ TRỢ TOÀN BỘ TRONG UNG THƯ TRỰC TRÀNG: NGHIÊN CỨU BỆNH - CHỨNG GHÉP CẶP

Abstract

Objective: To evaluate the initial outcomes and tolerance of total neoadjuvant therapy with the mFOLFIRINOX regimen compared to preoperative concurrent chemoradiotherapy in rectal cancer. Methods: A retrospective, case-control, matched study was conducted on a total of 44 patients, divided into two groups: the total neoadjuvant therapy (TNT) group and the control group receiving neoadjuvant chemoradiotherapy. Results: The mean age was 60.86 years in both groups, with a male-to-female ratio of 2.7:1. Most patients in the study had tumor stage cT3 and lymph node metastasis (cN1-2). 100% of TNT-treated patients completed six cycles of mFOLFOXIRI chemotherapy. The primary toxicities observed were hematologic toxicity and grade 1-2 peripheral neuropathy. Grade 3-4 toxicities were rare (Grade 3-4 neutropenia occurred in 23% of patients, but no cases of febrile neutropenia were reported, no cases of grade 3-4 thrombocytopenia or grade 3-4 liver enzyme elevation were observed). The rates of complete clinical response (cCR) and near-complete clinical response (nCR) were higher in the TNT group than in the chemoradiotherapy group (36% and 27% vs. 9.1% and 27%, respectively). At the end of the study, no patients in either group had experienced recurrence, metastasis, or death. Conclusion: Total neoadjuvant therapy with the mFOLFIRINOX regimen in patients with locally advanced mid-to-low rectal cancer demonstrated a high response rate and significant clinical benefits, with manageable toxicity. Further real-world clinical data are needed to refine treatment strategies.