الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 70 |  |  |
| | | from | 70 | | |
Abstract
NCCN recommends that patients with middle and lower third LARC should get trimodality treatment including neoadjuvant chemotherapy, surgical excision with TME, and adjuvant chemotherapy. However, many studies showed that this treatment strategy is related with low pCR rate (12 20%), and does not significantly improve patients’ survival.
Additionally, it has been shown that adding chemotherapy either before or after chemoradiotherapy may raise the rate of complete pathological response (pCR), suggesting that additional chemotherapy and standard chemoradiation work synergistically. The aforementioned factors, when combined with encouraging findings from early studies, offer an excellent basis for moving toward systemic treatment sooner in the treatment paradigm.
The current study aimed at evaluating the effectiveness and the safety of total neoadjuvant therapy (preoperative CRT + preoperative CT) + TME versus standard preoperative CRT + TME + adjuvant chemotherapy for LARC patients with respect on effects on pathological tumour downstaging using Mandard tumour regression grade, surgical difficulty and early functional outcome.