Conclusion: the incorporation of total neoadjuvant therapy(TNT) as the standard of care for patients with Locally advanced rectal carcinoma(LARC) would mean intensification of treatment as compared with chemoradiotherapy(CRT) alone with its associated toxicity, without conclusive evidence of improved response rates or overall survival.
Therefore, we feel that CRT should remain the standard of care for patients with LARC. Future research should focus on novel biomarkers, enabling identification of patients who will substantially benefit from a TNT regimen to justify the added toxicity.
