Wenshu Wang, Runyuan Zhao, Xi Liang, Manjun Liu, Haiyan Bai, Jianli Ge, Binxi Yao, Zheng Zhi, Jianming He
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引用次数: 0
Abstract
Background: An updated meta-analysis was conducted to evaluate the efficacy of radiotherapy in rectal cancer patients treated with total mesorectal excision (TME) or other types of surgery (non-TME-only).
Methods: The PubMed, Cochrane Library, and CNKI databases were searched. Data on overall survival (OS) were extracted.
Results: Hazard ratios (HRs) for OS associated with preoperative radiotherapy, preoperative long-course concurrent chemoradiotherapy (LCCRT), preoperative radiotherapy alone, and postoperative radiotherapy in patients treated with TME were 1.02 [95% CI: 0.92-1.14, P = 0.65], 1.04 [95% CI: 0.93-1.16, P = 0.47], 0.87 [95% CI: 0.61-1.25, P = 0.46], and 1.18 [95% CI: 0.91-1.52, P = 0.20], respectively. HRs for OS associated with preoperative radiotherapy, preoperative LCCRT, preoperative radiotherapy alone, preoperative long-course RT (LCRT), and preoperative short-course radiotherapy (SCRT) in patients treated with non-TME-only surgery were 0.85 [95% CI: 0.79-0.90, P < 0.00001], 0.77 [95% CI: 0.63-0.94, P = 0.009], 0.86 [95% CI: 0.80-0.92, P < 0.0001], 0.83 [95% CI: 0.73-0.95, P = 0.005], and 0.84 [95% CI: 0.77-0.91, P= <0.0001], respectively. The HR for postoperative radiotherapy in patients treated with non-TME-only surgery was 1.08 [95% CI: 0.84-1.39, P = 0.57].
Conclusion: Preoperative radiotherapy, regardless of the regimen, improves the OS in patients treated with non-TME-only surgery, but not in those treated with TME. Postoperative radiotherapy does not improve OS.
Advances in knowledge: This meta-analysis will serve as a reference for decision-making in multidisciplinary approaches for rectal cancer patients.
期刊介绍:
Oncology Reviews is a quarterly peer-reviewed, international journal that publishes authoritative state-of-the-art reviews on preclinical and clinical aspects of oncology. The journal will provide up-to-date information on the latest achievements in different fields of oncology for both practising clinicians and basic researchers. Oncology Reviews aims at being international in scope and readership, as reflected also by its Editorial Board, gathering the world leading experts in both pre-clinical research and everyday clinical practice. The journal is open for publication of supplements, monothematic issues and for publishing abstracts of scientific meetings; conditions can be obtained from the Editor-in-Chief or the publisher.