Background
tumor
TUMOR, RECURRENCE, RECTAL CANCER
Preoperative chemoradiotherapy (CRT) has long been the established treatment for locally advanced rectal cancer (LARC), effectively reducing the risk of local recurrence [The main distinction between TNT and traditional preoperative CRT lies in the use of intensive chemotherapy before surgery. The RAPIDO and PRODIGE 23 trials differ in terms of tumor location, cT stage, cN stage, and circumferential resection margin status. Moreover, the TNT protocols vary in the sequence of treatments, types and cycles of neoadjuvant chemotherapy, and types of radiotherapy employed [While preoperative CRT has served as the standard treatment for LARC over the years and continues to be utilized in many countries, including South Korea [Herein, we propose a neoadjuvant treatment protocol consisting of SCRT and four cycles of FOLFOX chemotherapy. Our randomized controlled trial aims to compare the 3-year DFS of patients with LARC treated with either preoperative CRT or SCRT followed by FOLFOX chemotherapy before total mesorectal excision (TME). We hypothesized that our protocol would yield superior systemic treatment effects compared to traditional CRT, reducing the total treatment period from the initiation of neoadjuvant treatment to the completion of adjuvant chemotherapy, and enhancing patient convenience.