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Rectal Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersRectal CancerSCE Medical Oncology

A 55-year-old man with locally advanced rectal cancer (cT3 N2 M0, low rectal tumour) is offered total neoadjuvant therapy (TNT). What does TNT involve?

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Correct answer: B — All systemic chemotherapy and radiotherapy delivered BEFORE surgery

Total neoadjuvant therapy (TNT) delivers all planned chemotherapy and chemoradiotherapy before surgery. The RAPIDO and PRODIGE 23 trials demonstrated improved pathological complete response rates, disease-free survival and reduced distant metastases with TNT compared with standard neoadjuvant CRT followed by surgery and adjuvant chemotherapy. TNT approaches include: induction chemotherapy → CRT → surgery (PRODIGE 23) or short-course RT → consolidation chemotherapy → surgery (RAPIDO).

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer