[메디컬투데이TV] Effective prior chemotherapy and radiation treatment before rectal cancer surgery

[메디컬투데이=최유진 기자] Rectal cancer treatment has the problem of worsening quality of life due to colostomy, severe changes in bowel habits such as fecal incontinence, and various side effects. However, recently, domestic researchers have recommended ‘total neoadjuvant chemotherapy and radiation therapy (TNT)’, a treatment strategy that preserves the rectum by administering both chemotherapy and radiation treatment before surgery, as a new standard treatment, and it has been found to have better treatment effects. .

At Chung-Ang University Hospital, Professor Park Byeong-gwan of Colorectal Surgery at the Cancer Center, together with a research team from Memorial Sloan Kettering Cancer Center in the U.S., published ‘A research paper on the effectiveness of anal preservation treatment in rectal cancer patients who received total prior chemotherapy and radiation therapy’. It was announced on the 21st that it was published in the latest issue of ‘Annals of Oncology’, a global journal of oncology.

‘Total neoadjuvant therapy (TNT)’ refers to the administration of both chemotherapy and radiation therapy before surgery. Compared to conventional preoperative radiation therapy, treatment compliance is higher and there is no remaining tumor. It has the advantage of having a high ‘complete response rate’.

In addition, in patients who show complete remission after ‘complete neoadjuvant chemotherapy’, organ preservation treatment (Non-operative Management) that preserves the rectum itself, rather than the existing anus preservation surgery, can be performed, eliminating problems such as fecal incontinence after colostomy surgery. There is an advantage to being able to avoid it.

From 2018 to 2021, the research team followed up 323 patients who underwent neoadjuvant chemotherapy and radiation therapy before rectal cancer surgery and analyzed survival rates and anal preservation rates. As a result, 142 patients showed complete response with no remaining tumor. It was confirmed that approximately 81% of patients had their anus and rectum preserved.

Among these, rectal cancer patients who underwent long-term chemotherapy and radiotherapy (LCCRT) showed an anal preservation rate of 84%, and patients who underwent short-term radiation therapy (SCRT) showed an anal preservation rate of 70%. Through this study, the research team confirmed for the first time that performing long-term chemotherapy and radiation therapy before surgery is effective in preserving the anus and survival rate in the treatment of rectal cancer.

Professor Park Byeong-kwan said, “Through this study, we hope that ‘total neoadjuvant chemotherapy and radiation therapy’ will be applied as a standard treatment method in the treatment of rectal cancer, which will help improve the treatment of patients.” He added, “In fact, in Korea, by 2024, He said, “I believe that from October of this year, ‘complete pre-emptive chemotherapy and radiation treatment’ will be included in the scope of reimbursement by the Health Insurance Review and Assessment Service, so it can be actively implemented.”

Professor Park continued, “The complete response rate and organ preservation rate after overall neoadjuvant treatment are clearly higher than those of existing treatments, but there is still sufficient evidence to determine which test to predict complete clinical response and what frequency and method to conduct follow-up tests in organ preservation patients. “This is not applicable to all patients and must be carried out with careful judgment by experts based on multiple tests and with sufficient understanding and consent,” he emphasized.

Medical Today Video Editing Team ([email protected])

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