💊 What Is TNT? скачать в хорошем качестве

💊 What Is TNT?

Total Neoadjuvant Therapy means delivering full-dose systemic chemotherapy (FOLFOX / FOLFIRINOX / CAPOX) before any radiation or surgery. The goal? Not just to shrink the tumor — but to eliminate micrometastases 🔬 across the body early. ⸻ 👥 Who Is TNT For? ✔️ Stage III rectal cancer ✔️ No involvement of the mesorectal fascia (MRF−) ✔️ High risk of distant recurrence (e.g., multiple positive lymph nodes, elevated CEA, EMVI+) 🧠 Treatment decision made by a multidisciplinary tumor board with high-resolution MRI assessment ⸻ ⚖️ Why Is This Approach So Powerful? ✅ Targets distant micrometastases from day one ✅ Allows for better systemic control ✅ Doubles the chance of a pathologic complete response (pCR) ✅ Opens the door for organ preservation ✅ Improves disease-free and overall survival ⸻ 🌐 What Does the Evidence Say? 📚 PRODIGE 23 (2024 – 7-year data): • pCR: 27.5% vs 11.7% • DFS (7-year): 67.6% vs 62.5% • OS (7-year): 81.9% vs 76.1% • MFS (7-year): 79.2% vs 72.3% ➡️ Strong survival benefit across all endpoints. — 📚 RAPIDO Trial (5-year results): • pCR: 28.4% vs 14.3% • Reduced distant metastases ⚠️ Slightly increased risk of local recurrence (10.2% vs 6.1%) if surgical technique is suboptimal ➡️ TNT boosts systemic control — but surgical precision remains key! — 📚 2024 Meta-analysis: • Both induction (iTNT) and consolidation (cTNT) improve pCR • cTNT = better pCR rates • iTNT = superior 3-year disease-specific & overall survival ➡️ Any TNT strategy outperforms standard chemoradiotherapy. — 📚 NCCN Guidelines 2025: • TNT is now the preferred first-line approach for Stage II–III rectal cancer ➡️ Not an alternative anymore — it’s becoming the standard. ⸻ 🎯 Take-Home Message: Out with the old — no more automatic radiation first In with the new — start with systemic therapy to strike early and hard 💥 📈 The result? • Better survival • More complete responses • Fewer metastases • Personalized, MRI-based treatment plans ⸻ 🧠 Every modern colorectal surgeon and oncologist in 2025 should be familiar with TNT. This is not the future — it’s the present. ⸻ 🗣️ Let’s talk: Is TNT part of your institutional protocol? 💬 Share your experience or questions in the comments below — we’re building a smarter, stronger oncology community together. 🔁 Like, share, and subscribe for more surgical oncology insights.