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@ARTICLE{Wurschi:305349,
      author       = {G. Wurschi and M. Kesselmeier and M. Schneider and J.-N.
                      Becker and B. Frerker and S. M. Vorbach and F. Ehret$^*$ and
                      M. Diefenhardt and F. Schunn and M.-E. von Gruben and M.
                      Büttner$^*$ and E. Hoffmann$^*$ and A. Rühle$^*$ and J.
                      Beier and S. Ferdinandus and M. Trommer and E. C. Sahin and
                      J. Hlouschek and K. Aninditha and D. S. von Ohlen and J.
                      Kaufmann and A. Depardon and H. M. Ha and S. Trommer and C.
                      Kessler and A. Cieslak and A. Fabian and F. Rißner and M.
                      Römer and M. Mäurer and K. Pietschmann},
      title        = {{S}hort-course radiotherapy versus long-course
                      chemoradiotherapy in total neoadjuvant therapy of rectal
                      cancer - {A} multicenter analysis of early outcomes and
                      toxicity.},
      journal      = {Radiotherapy and oncology},
      volume       = {213},
      issn         = {0167-8140},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2025-02093},
      pages        = {111194},
      year         = {2025},
      note         = {2025 Dec;213:111194},
      abstract     = {Total neoadjuvant therapy (TNT) improves local control and
                      complete response (CR) rates in locally advanced rectal
                      cancer (LARC). CR is associated with favorable local tumor
                      control, allowing non-operative management (NOM). However,
                      it remains unclear whether short-course radiotherapy (SCRT)
                      or long-course chemoradiotherapy (LCRT) is preferable within
                      TNT.LARC patients undergoing TNT between 2015 and 2024 were
                      included in this retrospective multicenter analysis
                      (DRKS00033000). The primary endpoint was CR. Secondary
                      endpoints comprised NOM rates, toxicity, and tumor control.
                      Multivariable logistic regression modelling was used to
                      assess the influence of LCRT.Of 295 included patients with a
                      median age at diagnosis of 62 (Q1-Q3: 54-68) years and 210
                      (71.2 $\%)$ men, 172 (58.3 $\%)$ underwent LCRT. CR was
                      achieved in 46 (37.4 $\%)$ SCRT and 96 (55.8 $\%)$ LCRT
                      patients. Acute toxicity grade ≥ 3 occurred in 24 (20.5
                      $\%)$ of 117 SCRT and in 62 (36.3 $\%)$ of 171 LCRT
                      patients. Within a median follow-up of 19.4 months (SCRT)
                      and 19.6 months (LCRT), 23 (19.8 $\%)$ of 116 and 30 (19.4
                      $\%)$ of 155 patients experienced recurrence, respectively.
                      Regression modelling revealed an increased likelihood for CR
                      (adjusted odds ratio: 3.11; 95 $\%$ confidence interval:
                      1.37-7.07) and NOM (4.40; 1.46-13.21) with LCRT, whereas no
                      significant associations of LCRT with acute toxicity (0.90;
                      0.40-2.02), chronic toxicity (1.16; 0.48-2.78),
                      postoperative complications (0.89; 0.62-1.28) or recurrence
                      (0.81; 0.31-2.16) were observed.LCRT was associated with
                      higher CR and NOM rates. Whether it might be preferred over
                      SCRT for intended NOM remains a relevant question to be
                      answered by ongoing randomized trials.},
      keywords     = {Chemoradiotherapy (Other) / Complete response (Other) /
                      Rectal cancer (Other) / Total neoadjuvant therapy (Other)},
      cin          = {BE01 / TU01 / FR01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331 / I:(DE-He78)TU01-20160331 /
                      I:(DE-He78)FR01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41077142},
      doi          = {10.1016/j.radonc.2025.111194},
      url          = {https://inrepo02.dkfz.de/record/305349},
}