Modified Sandwich Therapeutic Regimen for Locally Advanced Rectal Cancer
Status:
Not yet recruiting
Trial end date:
2028-05-01
Target enrollment:
Participant gender:
Summary
In the treatment of locally advanced rectal cancer, the short-term and long-term efficacy of
the traditional sandwich regimen has not reached satisfactory efficacy. For this reason, the
concept of reducing the dose of postoperative chemotherapy or directly moving forward the
full amount of postoperative chemotherapy was proposed, which is called total neoadjuvant
therapy (TNT). However, TNT also includes the high toxicity of oxaliplatin in the whole
process and the long time interval between the end of radiotherapy and the operation, which
leads to fibrosis of the surrounding tissue, which increases the difficulty of surgical
resection and makes it difficult to ensure good surgical specimen quality. In addition to
this, there are issues that may increase the risk of potential disease progression in
patients with poor treatment withdrawal. Therefore, appropriately reducing the intensity of
chemotherapy and controlling the total duration of preoperative neoadjuvant therapy during
radiotherapy is expected to alleviate the side effects of neoadjuvant therapy. Here, the
investigators synthesized the characteristics of TNT and sandwich regimens and proposed a
XELOX regimen and capecitabine alternate administration combined with preoperative intensity
modulated radiation therapy.