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Total neoadjuvant therapy versus standard neoadjuvant treatment strategies for the management of locally advanced rectal cancer: network meta-analysis of randomized clinical trials

Donnelly M, Ryan OK,  Ryan EJ, Creavin B, O’Reilly M, McDermott R et al.

Br J Surg 2023; 110: 1316-1330.

Total neoadjuvant treatment involves completion of all chemoradiotherapy preoperatively. This analysis of 15 RCTs including 4602 patients showed improved overall survival compared with short course and long course chemoradiotherapy. It also improved pathological complete response rate.

Comment: This could be a gamechanger.

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