Abstract: Clinical application progress of total neoadjuvant therapy for locally advanced rectal cancer        WANG Ye, LOU Zheng, JI Li-qiang, et al. Department of Colorectal Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
Corresponding author: LOU Zheng, E-mail: louzhengpro@126.com
Abstract    Total neoadjuvant therapy （TNT）is to advance postoperative adjuvant therapy to the preoperative period. Early systemic and effective treatment is used to eliminate tumor micrometastases and improve treatment compliance. Available studies suggest that TNT may have a better survival benefit compared to neoadjuvant therapy. At present, the two main modes of TNT are induction chemotherapy and consolidation chemotherapy, and both treatment modes have their own advantages. For patients with a high risk of distant metastases, seeking to avoid radiotherapy damage and close the stoma early, induction chemotherapy mode may be attempted. Consolidation chemotherapy may be more beneficial for patients who have a strong desire to preserve anus, who are trying a "watch and wait" strategy, and who have severe pelvic symptoms from rectal cancer. 

Key words: rectal neoplasms, total neoadjuvant therapy, prognosis

摘要： 全程新辅助治疗（TNT）是将术后的辅助治疗提前至术前，早期进行全身有效治疗以消除肿瘤微转移灶，同时提高病人治疗依从性。与新辅助治疗相比，TNT可能使病人具有更好的生存效益。目前，TNT主要有诱导化疗和巩固化疗两种模式，各具优势。对于远处转移风险高、试图避免放疗损伤和早期还纳造口的病人，可尝试选择诱导化疗模式；对于保肛意愿强烈，或拟行“观察等待”策略，以及直肠癌盆腔症状严重的病人，巩固化疗可能使病人获益更多。

关键词: 直肠肿瘤, 全程新辅助治疗, 预后