Induction chemotherapy followed by neoadjuvant chemoradiotherapy and surgery for patients with locally advanced rectal cancer: a systematic review and meta-analysis

doi:10.1007/s00384-020-03621-y

	Induction chemotherapy followed by neoadjuvant chemoradiotherapy and surgery for patients with locally advanced rectal cancer: a systematic review and meta-analysis
	Feng, Shuangwu 1; Yan, Peijing 2; Zhang, Qiuning 3,4; Li, Zheng 3; Li, Chengcheng 1; Geng, Yichao 1; Wang, Lina 1; Zhao, Xueshan 1; Yang, Zhen 5; Cai, Hongyi 6
刊名	INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
	2020-06-01
页码	15
关键词	Induction chemotherapy Rectal cancer Neoadjuvant therapy Systematic review Meta-analysis
ISSN号	0179-1958
DOI	10.1007/s00384-020-03621-y
通讯作者	Wang, Xiaohu(xhwanggansu@163.com)
英文摘要	Background 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). Methods We searched the PubMed, EMBASE, Cochrane Library, and China Biology Medicine (CBM) databases. The data were analyzed with Stata version 12.0 software. Results 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). Conclusions The addition of ICT before NCRT seemingly shows no survival benefit on patients with LARC, and might increase the toxicity.
资助项目	Lanzhou Innovation and Entrepreneurship Talent Project[2017-RC-23]
WOS关键词	TOTAL MESORECTAL EXCISION ; POSTOPERATIVE CHEMORADIOTHERAPY ; NONOPERATIVE MANAGEMENT ; CONCOMITANT CHEMORADIOTHERAPY ; PREOPERATIVE RADIOTHERAPY ; METHODOLOGICAL QUALITY ; CHEMORADIATION THERAPY ; MARGIN INVOLVEMENT ; SURGICAL RESECTION ; PHASE-II
WOS研究方向	Gastroenterology & Hepatology ; Surgery
语种	英语
出版者	SPRINGER
WOS记录号	WOS:000537334200001
资助机构	Lanzhou Innovation and Entrepreneurship Talent Project
内容类型	期刊论文
源URL	[http://119.78.100.186/handle/113462/140800]
专题	中国科学院近代物理研究所
通讯作者	Wang, Xiaohu
作者单位	1.Lanzhou Univ, Sch Clin Med 1, Lanzhou 730000, Peoples R China 2.Sichuan Univ, West China Hosp, Dept Clin Res Management, Chengdu 610041, Peoples R China 3.Chinese Acad Sci, Inst Modern Phys, Lanzhou 730000, Peoples R China 4.Lanzhou Heavy Ions Hosp, Lanzhou 730000, Peoples R China 5.Lanzhou Univ, Sch Basic Med Sci, Lanzhou 730000, Peoples R China 6.Gansu Prov Peoples Hosp, Dept Radiat Oncol, Lanzhou 730000, Peoples R 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,2020:15.
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,15.
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 (2020):15.