Impact of total neoadjuvant therapy regimens on radiation-induced lymphopenia in locally advanced rectal cancer: a retrospective analysis.

ABSTRACT: Total neoadjuvant therapy (TNT) improves oncological outcomes in locally advanced rectal cancer (LARC); however, treatment-induced lymphopenia remains a concern. We analyzed 74 patients undergoing three TNT regimens: long-course chemoradiotherapy with consolidation chemotherapy (LCCRT-CNCT), short-course radiotherapy with CNCT (SCRT-CNCT), and induction chemotherapy with LCCRT (INCT-LCCRT). Severe radiation-induced lymphopenia (RIL, Grade ≥ 3) occurred in 48%, 24%, and 54%, respectively (P = 0.126). In the LCCRT-CNCT group, large bowel irradiation (V35 Gy > 46 cc) was significantly associated with severe RIL in univariable analysis but not in multivariable models (P = 0.227), and in an exploratory combined analysis of LCCRT-CNCT and INCT-LCCRT, this showed a trend (P = 0.093). Pre-TNT abso

SUBMITTER: Sasaki R 

PROVIDER: S-EPMC12648072 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature