KẾT QUẢ HOÁ XẠ TRỊ TÂN BỔ TRỢ TOÀN PHẦN UNG THƯ TRỰC TRÀNG GIAI ĐOẠN II, III TẠI BỆNH VIỆN K

Abstract

Objective: To evaluate early outcome and some toxicity/side effect of total neoadjuvant chemoradiation (TNT - Total neoadjuvant therapy) in stage II, III rectal cancer patients at K Hospital. Subject and Methods: We did a descriptive retrospective and prospective study at K Hospital. Thirty - seven patients with locally advanced (stages II and III) rectal cancer, who underwent induction chemotherapy followed by neoadjuvant chemoradiation between october 2022 and june 2025. Results: The mean age was 56 years old, a male-to-female ratio was 1,64:1. Hematochezia was the most common presenting symptom. All patients had an ECOG performance status of 0–1. The clinical stages cT3 and cT4 accounted for 62.1% and 35.1%. All patients had nodal involvement (cN1–2), with 50,0% having positive mesorectal fascia (MRF) and 21,6% positive extramural vascular invasion (EMVI). After treatment, the primary endpoint—pathological complete response rate (pCR) was 28,1%, near-complete responses and partial responses were observed in 9,4% and 62,5%. EMVI conversion to negative was observed in 71,4% of cases. The anal sphincter preservation rate was 75%. Toxicities were mainly hematologic and hepatic, with most being grade 1–2. Grade 3–4 neutropenia occurred in 13,6% of patients. Other toxicities included palmar-plantar erythrodysaesthesia, radiation dermatitis, and radiation proctitis were mostly grade 1–2 and manageable. No treatment discontinuations or treatment-related deaths were reported. Conclusion: Total neoadjuvant therapy with induction chemotherapy followed by chemoradiation has shown promising efficacy, including in pCR rate, anal sphincter preservation and a potential reduction in distant metastasis risk. Treatment-related toxicities were manageable.