Background: Total neoadjuvant therapy (TNT) has emerged as a promising strategy for locally advanced rectal cancer (LARC). By administering both chemoradiotherapy (CRT) and systemic chemotherapy (CHT) pre-surgery, TNT is associated with improved disease-free survival (DFS), reduced distant metastases, and higher pathological complete response (pCR) rates. Materials and Methods: This study included patients with LARC who received various TNT schedules: induction chemotherapy (iCHT), consolidation chemotherapy (cCHT), or a combination of both (sandwichCHT). We analyzed treatment adherence, toxicity, and pathological response. Local and distant disease recurrence, as well as survival outcomes, were also evaluated. Results: Between May 2021 and January 2025, 70 patients received TNT. Treatment included iCHT (41%), sandwichCHT (49%), and cCHT (10%). Most patients (94%) received long-course radiotherapy (LCRT). Overall, TNT was well tolerated, with grade 2 gastrointestinal toxicity during CRT being the most common frequent adverse event (33%). Disease progression during TNT was noted in five patients (7%); three of these patients were receiving chemotherapy, while two underwent surgical resection of the primary tumor. A watch-and-wait strategy was adopted for five patients (7%) following TNT. Surgical procedures performed included anterior resection (92%), abdominoperineal resection (7%), and local excision (1%). Pathological assessment revealed an overall pCR rate of 30%. With a median follow-up of 17 months, no patients experienced local recurrence. Post-surgery, 10 patients (17%) developed disease progression. The median DFS was 14.7 months. Five patients (7%) died during the follow-up period, with only one death attributed to causes other than disease progression. Conclusions: In this cohort of LARC patients, TNT demonstrated favorable tolerability and encouraging short-term efficacy.

Background/Objectives: The neutrophil-to-lymphocyte ratio (NLR) is a simple biomarker reflecting systemic inflammatory status and has been investigated in head and neck cancer (HNC) as a potential prognostic indicator. Its role in relation to radiotherapy-related toxicity remains uncertain. The aim of this study was to provide a descriptive evaluation of NLR values in relation to oral mucositis severity and swallowing-related quality of life in patients undergoing radiotherapy-based treatment. Methods: We retrospectively evaluated 32 patients with locally advanced HNC treated with radiotherapy, with or without concomitant chemotherapy, in the definitive or adjuvant setting (March 2025–January 2026). NLR was calculated at baseline (T0), at a predefined mid-treatment timepoint (T3), and during week 6 of treatment (T6). Mucositis severity was assessed using CTCAE and the Oral Mucositis Assessment Scale (OMAS), while swallowing-related quality of life was measured using the MD Anderson Dysphagia Inventory (MDADI). Relationships between NLR values and toxicity endpoints were descriptively assessed using Spearman correlation analysis. Results: No statistically significant correlations were observed between NLR values and OM severity or swallowing-related outcomes at any evaluated timepoint. At T3, non-significant correlations were observed between NLR and CTCAE mucositis grade and between NLR and MDADI global score. No statistically significant correlations were observed between NLR values and OMAS at any evaluated timepoint. Conclusions: In this retrospective cohort, no association between NLR and radiotherapy-related mucositis severity or swallowing-related quality of life was demonstrated. These findings are descriptive and limited by the small sample size, the retrospective design, and the absence of control for potential confounding factors. No inferential or causal conclusions can be drawn. Further prospective studies with larger and more homogeneous cohorts are required to better characterize NLR behavior in this clinical setting.

Background/Objectives: Oral mucositis is a frequent and clinically significant acute toxicity in patients undergoing radiotherapy or chemoradiotherapy for head and neck cancer, with substantial consequences for swallowing function, nutritional status, and quality of life. Conventional clinician-reported toxicity grading may not fully capture the multidimensional burden experienced by patients. This study aimed to perform a longitudinal multidimensional assessment of treatment-related oral mucositis by evaluating the relationship between clinician-reported toxicity, objective mucosal injury, patient-reported swallowing-related quality of life, and nutritional status. Methods: In this retrospective observational study, 32 of 54 consecutively screened patients with locally advanced head and neck cancer treated with curative-intent radiotherapy, with or without concurrent chemotherapy, were included. Oral mucositis was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) and the Oral Mucositis Assessment Scale (OMAS). Swallowing-related quality of life was evaluated using the MD Anderson Dysphagia Inventory (MDADI). Body weight was recorded longitudinally as an indicator of nutritional status. Correlations between OMAS scores and clinical outcome measures were analyzed at predefined timepoints using Spearman’s rank correlation coefficient. Results: All patients developed treatment-related oral mucositis, with peak severity occurring during the acute treatment phase. During the acute treatment phase, OMAS scores demonstrated a moderate positive correlation with clinician-reported toxicity (CTCAE) and inverse correlations with MDADI scores. A significant inverse association between OMAS and MDADI composite score persisted at treatment completion (ρ = −0.41, p = 0.022). Body weight progressively declined during treatment, although no statistically significant correlation with OMAS severity was observed. Conclusions: A multidimensional assessment integrating clinician-reported toxicity, objective mucosal evaluation, and patient-reported functional outcomes provides a broader characterization of oral mucositis burden in patients undergoing radiotherapy-based treatment for head and neck cancer. These findings support the potential value of integrated toxicity assessment strategies to improve supportive care monitoring in clinical practice.