{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:13:42Z","timestamp":1790712822163,"version":"4.1.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1186","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"South-Eastern Norway Regional Health Authority, Grant","award":["2018054"],"award-info":[{"award-number":["2018054"]}],"id":[{"id":"https:\/\/ror.org\/001212e83","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC) often uses intensive oxaliplatin-based chemotherapy alongside standard radiotherapy to prevent metastatic progression. The optimal intensity of the chemotherapy component, given a contribution of radiotherapy to clonogenic cell elimination in the primary tumor, remains uncertain. We aimed to assess long-term outcomes of a TNT regimen with low-intensity induction chemotherapy before chemoradiotherapy, as evaluated in the LARC-RRP trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2005 and 2010, 87 LARC patients (36% with T4 organ-infiltrating tumor) were enrolled in the single-arm trial. Induction chemotherapy was given over 4 weeks prior to chemoradiotherapy and surgery. We report 10-year overall survival by tumor regression grade (TRG) and performed descriptive comparisons with contemporary trials whose experimental TNT arms used more intensive chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 10\u2009years, overall survival was 83% (95% confidence interval, 71-90) for patients with complete or near-complete tumor cell elimination in the surgical specimen (TRG 1-2; 70% of the cohort) versus 52% (95% confidence interval, 31-69) for others (log-rank P\u2009=\u2009.0005). LARC-RRP survival outcomes were comparable with those reported in more contemporary TNT trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The LARC-RRP results raise the possibility that shorter-duration chemotherapy combined with standard radiotherapy may suffice to protect against systemic recurrence of high-risk LARC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>These long-term data support investigation of less intensive chemotherapy within TNT regimens and may guide the design of risk-stratified TNT trials.<\/jats:p>\n                  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