Total neoadjuvant treatment versus chemoradiotherapy in locally advanced rectal cancer: A propensity score analysis from two prospective phase II clinical trials.

3600Background: Fluorouracil-based neoadjuvant chemoradiotherapy (CRT) is still the standard of treatment for locally advanced rectal cancer, but it delays administration of systemic chemotherapy, leading to high incidence of distant metastases. To enhance systemic chemotherapy and improve the outcome of rectal cancer, totally neoadjuvant therapy (TNT) has been investigated recently. Here, we aimed to compare the efficacy of TNT with CRT in locally advanced rectal cancer. Methods: A total of 180 patients with clinical stage II or III locally advanced rectal cancer who received either total neoadjuvant treatment (n = 79) or CRT (n = 101) followed by total mesorectal excision (TME) were identified from two prospective clinical trials (NCT01211210 and NCT02217020) in our institutional database. Propensity score analysis was performed to mitigate selection biases. The patients in TNT group received 1 cycle of mFOLFOX6 as induction chemotherapy and radiotherapy would be delivered accompanied with 3 cycles of m...