Retrospective review of total neoadjuvant therapy

Table 1 Comparative use of total neoadjuvant treatment vs conventional neoadjuvant treatment approach by baseline characteristics in patients receiving treatment for rectal adenocarcinoma

Characteristic	TNT, n = 254 (%)	Conventional neoadjuvant treatment, n = 8812 (%)	OR	95%CI	P value
Sex
Male	151 (59)	5497 (62)	1	Ref
Female	103 (41)	3315 (38)	1.13	0.88-1.46	0.34
Race
White	205 (81)	7757 (88)	1	Ref
African American	22 (8)	624 (7)	1.33	0.85-2.09	0.21
Other	27 (11)	431 (5)	2.37	1.57-3.58	< 0.0001
Comorbidity score
0	224 (88)	7175 (81)	1	Ref
1	27 (11)	1366 (16)	0.63	0.42-0.95	0.026
≥ 2	3 (1)	271 (3)	0.35	0.11-1.11	0.08
Insurance
Not Insured	9 (3)	417 (5)	1	Ref
Private Payer	178 (70)	5313 (60)	1.55	0.79-3.05	0.20
Government	63 (25)	2981 (34)	0.98	0.48-1.98	0.95
Unrecorded	4 (2)	101 (1)	1.84	0.55-6.08	0.32
Education %
≥ 29	39 (15)	1262 (14)	1	Ref
20 to 28.9	53 (21)	2231 (25)	0.77	0.51-1.17	0.22
14 to 19.9	84 (33)	2960 (34)	0.92	0.62-1.35	0.66
Locations
Metro	209 (82)	6915 (78)	1	Ref
Urban	16 (6)	1474 (17)	0.36	0.22-0.60	0.0001
Rural	4 (2)	207 (2)	0.64	0.24-1.74	0.38
Unrecorded	25 (10)	216 (2)	3.83	2.48-5.92	< 0.0001
Income, United States dollars
< 30000	25 (10)	1391 (16)	1	Ref
30000 to 35000	37 (15)	2086 (24)	0.99	0.59-1.65	0.96
35000 to 45999	53 (20)	2510 (29)	1.17	0.73-1.90	0.51
> 46000	139 (55)	2773 (31)	2.79	1.81-4.29	< 0.0001
Distance to treatment facility, miles
≤ 8.5	82 (32)	3561 (41)	1	Ref
> 8.5	172 (68)	5205 (59)	1.44	1.10-1.87	0.0079
Age distribution in yr
≤ 65	208 (82)	6734 (76)	1	Ref
> 65	46 (18)	2078 (24)	0.72	0.52-0.99	0.04
Year of diagnosis
2004-2006	11 (4)	1125 (13)	1	Ref
2007-2009	19 (7)	2256 (26)	0.86	0.41-1.82	0.69
2010-2012	73 (29)	3097 (35)	2.41	1.27-4.56	0.0068
2013-2015	151 (59)	2334 (26)	6.62	3.57-12.25	<0.0001
Stage grouping
2	50 (20)	3644 (41)	1	Ref
3	204 (80)	5168 (59)	2.88	2.11-3.93	< 0.0001
Nodes
0	170 (67)	5277 (60)	1	Ref
1	25 (10)	1089 (12)	0.71	0.47-1.09	0.12

TNT: Total neoadjuvant therapy.

Table 2 Different surgery/chemoradiation protocols used per standard guidelines

Treatment type	Protocol used
nCRT	50-55Gy/25-28 fx with concurrent 5-fluorouracil (5-FU) or capecitabine1
Post-op MaChT	Excisional surgery followed by postoperative (i.e. adjuvant) chemotherapy with 5-FU based regimens1
TNT	25-35Gy/5 fx followed by CAPOX or FOLFOX chemotherapy

1nCRT and MaChT are usually used in conjunction with each other in traditional chemoradiation therapy. nCRT: Neoadjuvant chemoradiotherapy; MaChT: Multi-agent chemotherapy; TNT: Total neoadjuvant therapy.