Multidisciplinary Perspectives on Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Results of a National Survey


Aksoy R. A., RAKICI S., ALTMIŞDÖRTOĞLU Ö., TELATAR T. G.

Turk Onkoloji Dergisi, cilt.41, sa.1, ss.10-17, 2026 (ESCI, Scopus, TRDizin) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 41 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.5505/tjo.2025.4681
  • Dergi Adı: Turk Onkoloji Dergisi
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.10-17
  • Anahtar Kelimeler: Current practice, physician perspective, rectal cancer, survey, total neoadjuvant therapy
  • Recep Tayyip Erdoğan Üniversitesi Adresli: Evet

Özet

OBJECTIVE Rectal cancer is a leading cause of cancer-related deaths, with total neoadjuvant therapy (TNT) emerging as a key treatment for locally advanced rectal cancer (LARC). However, its clinical application varies due to differing protocols and physician preferences. This study explores physician perspectives on TNT in LARC management. METHODS An online survey was conducted among radiation oncologists, medical oncologists, and colorectal surgeons in Türkiye. The questionnaire, consisting of 24 questions, addressed demographics, staging, treatment sequencing, radiotherapy, chemotherapy regimens, and response evaluation. Responses were analyzed using descriptive statistics, with comparisons made between specialties using chi-square or Fisher’s exact test. RESULTS A total of 103 participants completed the survey, with 68.9% agreeing on the standardization of TNT as the neoadjuvant treatment for LARC. While no statistically significant differences were observed across specialties, medical oncologists more frequently supported TNT as the standard approach (81.8%) compared to colorectal surgeons (70%) and radiation oncologists (60%). Factors influencing treatment choices included tumor staging, with N stage being the most significant determinant (32%). Opinions on treatment sequencing within TNT were split, with a nearly even distribution between chemotherapy-first and radiotherapy-first approaches. CONCLUSION This nationwide survey indicates that, while many clinicians support TNT as a neoadjuvant treatment for LARC, there remains considerable heterogeneity in clinical approaches, and full consensus among specialties has not yet been achieved. Strengthening evidence-based guidelines and enhancing multidisciplinary collaboration are needed to reduce practice variability and improve patient care.