Short-course versus long-course neoadjuvant radiotherapy combined with delayed surgery for locally advanced rectal cancer: a Meta-analysis
10.3760/cma.j.issn.1004-4221.2019.12.005
- VernacularTitle: 局部晚期直肠癌短程新辅助放疗与长程新辅助放疗联合延迟手术疗效比较
- Author:
Xingyu XU
1
;
Yaqin DONG
2
;
Lin YANG
2
;
Maoming XIONG
1
Author Information
1. Department of Gastroenterology Surgery First Affiliated Hospital Anhui Medical University Hefei 230000 Cina
2. Department of Radiation Oncology First Affiliated Hospital Anhui Medical University Hefei 230000 Cina
- Publication Type:Journal Article
- Keywords:
Rectal neoplasm/neoadjuvant radiotherapy;
Rectal neoplasm/surgery;
Meta-analysis
- From:
Chinese Journal of Radiation Oncology
2019;28(12):901-904
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Short-course neoadjuvant radiotherapy (SCRT) combined with delayed surgery seems to be safer than SCRT in combination with immediate surgery. However, the clinical efficacy between SCRT and long-course neoadjuvant radiotherapy (LCRT) combined with delayed surgery has not been compared. Therefore, this meta-analysis was performed to compare the safety and efficacy between SCRT and LCRT followed by delayed surgery in patients with locally advanced rectal cancer.
Methods:Relevant literatures were searched using relevant databases. Baseline characteristics and treatment results of patients were extracted. The included studies were subject to bias risk assessment. Evidence assessment and data analysis were conducted.
Results:A total of 7 studies with 4967 patients were included. Meta-analysis results illustrated no statistical significance between two groups in terms of sphincter preservation rate, R0 resection rate, postoperative complications, local recurrence rate (LRR), distant metastasis, recurrence-free survival (RFS), overall survival (OS), length of hospital stay and acute radiotherapy toxicity (all P>0.05). Compared with SCRT with delayed surgery, LCRT with delayed surgery was associated with a significant increase in the tumor downstaging rate (RR=0.84, 95%CI=0.76-0.93, P<0.05) and a considerable increase in pathologically complete remission rate (RR=0.46, 95%CI=0.34-0.61, P<0.05).
Conclusions:SCRT with delayed surgery is as effective as LCRT with delayed surgery in terms of sphincter preservation rate, R0 resection rate, postoperative complications, LRR, RFS, OS, grade Ⅲ-Ⅳ acute toxicity and length of hospital stay. However, LCRT in combination with delayed surgery enhances the tumor downstaging rate and pathologically complete remission rate.
