Induction chemotherapy followed by neoadjuvant chemoradiotherapy and surgery for patients with locally advanced rectal cancer: a systematic review and meta-analysis.
机构：[1]The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China[2]Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610041, China四川大学华西医院[3]Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China[4]Lanzhou Heavy Ions Hospital, Lanzhou 730000, China[5]School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China[6]Department of Radiation Oncology, Gansu Province People’s Hospital, Lanzhou 730000, China
Controversy persists about whether additional induction chemotherapy (ICT) before neoadjuvant chemoradiation (NCRT) yields improved oncological outcomes. We performed a systematic review and meta-analysis to compare ICT+ NCRT+ surgery(S) with NCRT+ S in patients with locally advanced rectal cancer (LARC).
We searched the PubMed, EMBASE, Cochrane Library, and China Biology Medicine (CBM) databases. The data were analyzed with Stata version 12.0 software.
We identified 9 relevant trials that enrolled 1538 patients. We detected no significant difference in the 5-year overall survival (OS) (OR 1.50, 95% CI 0.48-4.64), disease-free survival (DFS) (OR 1.03, 95% CI 0.73-1.46), local recurrence (LR) (OR 0.80, 95% CI 0.45-1.43), and distant metastasis (DM) rates (OR 1.03, 95% CI 0.55-1.93) between patients who did and did not receive ICT. The addition of ICT before NCRT had a similar pathological complete response rate compared to NCRT (OR 1.26, 95% CI 0.90-1.77). Our findings suggest that between the ICT + NCRT+S and NCRT+S groups, ICT improved the incidence of grade 3 to 4 toxicity effects (OR 4.81, 95% CI 2.38-9.37), but between the ICT + NCRT+S and NCRT+S+ adjuvant chemotherapy (ACT) groups, ICT might reduce toxicity (OR 0.19, 95% CI 0.08-0.50). ICT had no significant impact on surgical complications (OR 0.97, 95% CI 0.63-1.51).
The addition of ICT before NCRT seemingly shows no survival benefit on patients with LARC, and might increase the toxicity.
基金：
This work is supported by the Lanzhou Innovation
and Entrepreneurship Talent Project (award number 2017-RC-23, recipient: Xiaohu Wang).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2020]版：
大类|3 区医学
小类|3 区外科4 区胃肠肝病学
最新[2023]版：
大类|3 区医学
小类|3 区外科4 区胃肠肝病学
第一作者：
第一作者机构：[1]The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
共同第一作者：
通讯作者：
通讯机构：[1]The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China[3]Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China[4]Lanzhou Heavy Ions Hospital, Lanzhou 730000, China
推荐引用方式(GB/T 7714)：
Feng Shuangwu,Yan Peijing,Zhang Qiuning,et al.Induction chemotherapy followed by neoadjuvant chemoradiotherapy and surgery for patients with locally advanced rectal cancer: a systematic review and meta-analysis.[J].International journal of colorectal disease.2020,35(8):1355-1369.doi:10.1007/s00384-020-03621-y.
APA：
Feng Shuangwu,Yan Peijing,Zhang Qiuning,Li Zheng,Li Chengcheng...&Wang Xiaohu.(2020).Induction chemotherapy followed by neoadjuvant chemoradiotherapy and surgery for patients with locally advanced rectal cancer: a systematic review and meta-analysis..International journal of colorectal disease,35,(8)
MLA：
Feng Shuangwu,et al."Induction chemotherapy followed by neoadjuvant chemoradiotherapy and surgery for patients with locally advanced rectal cancer: a systematic review and meta-analysis.".International journal of colorectal disease 35..8(2020):1355-1369
