Wenshu Wang, Runyuan Zhao, Xi Liang, Manjun Liu, Haiyan Bai, Jianli Ge, Binxi Yao, Zheng Zhi, Jianming He
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Data on overall survival (OS) were extracted.</p><p><strong>Results: </strong>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].</p><p><strong>Conclusion: </strong>Preoperative radiotherapy, regardless of the regimen, improves the OS in patients treated with non-TME-only surgery, but not in those treated with TME. 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Data on overall survival (OS) were extracted.</p><p><strong>Results: </strong>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. 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引用次数: 0
摘要
背景：进行了一项最新的荟萃分析，以评估放疗对直肠癌患者全肠系膜切除术（TME）或其他类型手术（非TME）的疗效。方法：检索PubMed、Cochrane Library、CNKI数据库。提取总生存期（OS）数据。结果：TME患者术前放疗、术前长疗程同步放化疗（LCCRT）、术前单独放疗和术后放疗相关OS的风险比（hr）分别为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]和1.18 [95% CI: 0.91-1.52, P = 0.20]。非tme手术患者术前放疗、术前LCCRT、术前单独放疗、术前长程放疗（LCRT）和术前短程放疗（SCRT）相关OS的hr分别为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]和0.84 [95% CI: 0.77-0.91， P=结论：术前放疗，无论何种治疗方案，均可改善非单纯TME手术患者的OS，而非单纯TME患者的OS。术后放疗不能改善OS。知识进展：本荟萃分析将为直肠癌患者多学科治疗决策提供参考。
Efficacies of radiotherapy in rectal cancer patients treated with total mesorectal excision or other types of surgery: an updated meta-analysis.
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.
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