L Zhao1, R Liu1,2, Z Zhang1,2, T Li1, F Li1, H Liu1, G Li1. 1. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. 2. Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Abstract
AIM: Previous randomized controlled trials and meta-analyses have demonstrated the ineffectiveness of fluorouracil-based adjuvant chemotherapy for patients with rectal cancer who have undergone neoadjuvant chemoradiotherapy and subsequent surgery. The role of oxaliplatin/fluorouracil-based adjuvant chemotherapy in such patients is unknown. We performed a meta-analysis to evaluate the efficacy of oxaliplatin/fluorouracil-based adjuvant chemotherapy based on a comparison with fluorouracil-based adjuvant chemotherapy for patients with rectal cancer. METHOD: A literature search of MEDLINE, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov was performed to identify eligible studies. The primary end-point of interest was disease-free survival (DFS). The secondary end-points were overall survival, compliance and the incidence of Grade 3 or 4 toxicity. RESULTS: The literature search identified four randomized controlled trials that met the inclusion criteria for the meta-analysis, and 2793 patients with pathological TNM or clinical TNM Stage II or III disease were included. The meta-analysis showed that oxaliplatin/fluorouracil-based adjuvant chemotherapy was associated with a significantly improved DFS (hazard ratio 0.85; 95% CI 0.73-0.98; P = 0.03), comparable compliance (OR 1.18; 95% CI 0.95-1.46; P = 0.13) and a higher incidence of vomiting or nausea (OR 2.47; 95% CI 1.21-5.05; P = 0.01). No significant differences were observed between the groups with respect to overall survival and the incidence of leucopaenia, anaemia, thrombocytopaenia and diarrhoea. CONCLUSION: Adjuvant oxaliplatin/fluorouracil-based chemotherapy can improve the DFS of patients after neoadjuvant chemoradiotherapy and radical surgery, compared with adjuvant fluorouracil-based chemotherapy. Data of the longer-term survival outcome are needed. Colorectal Disease
AIM: Previous randomized controlled trials and meta-analyses have demonstrated the ineffectiveness of fluorouracil-based adjuvant chemotherapy for patients with rectal cancer who have undergone neoadjuvant chemoradiotherapy and subsequent surgery. The role of oxaliplatin/fluorouracil-based adjuvant chemotherapy in such patients is unknown. We performed a meta-analysis to evaluate the efficacy of oxaliplatin/fluorouracil-based adjuvant chemotherapy based on a comparison with fluorouracil-based adjuvant chemotherapy for patients with rectal cancer. METHOD: A literature search of MEDLINE, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov was performed to identify eligible studies. The primary end-point of interest was disease-free survival (DFS). The secondary end-points were overall survival, compliance and the incidence of Grade 3 or 4 toxicity. RESULTS: The literature search identified four randomized controlled trials that met the inclusion criteria for the meta-analysis, and 2793 patients with pathological TNM or clinical TNM Stage II or III disease were included. The meta-analysis showed that oxaliplatin/fluorouracil-based adjuvant chemotherapy was associated with a significantly improved DFS (hazard ratio 0.85; 95% CI 0.73-0.98; P = 0.03), comparable compliance (OR 1.18; 95% CI 0.95-1.46; P = 0.13) and a higher incidence of vomiting or nausea (OR 2.47; 95% CI 1.21-5.05; P = 0.01). No significant differences were observed between the groups with respect to overall survival and the incidence of leucopaenia, anaemia, thrombocytopaenia and diarrhoea. CONCLUSION: Adjuvant oxaliplatin/fluorouracil-based chemotherapy can improve the DFS of patients after neoadjuvant chemoradiotherapy and radical surgery, compared with adjuvant fluorouracil-based chemotherapy. Data of the longer-term survival outcome are needed. Colorectal Disease
Authors: Jeanne Tie; Joshua D Cohen; Bert Volgestein; Peter Gibbs; Yuxuan Wang; Lu Li; Michael Christie; Koen Simons; Hany Elsaleh; Suzanne Kosmider; Rachel Wong; Desmond Yip; Margaret Lee; Ben Tran; David Rangiah; Matthew Burge; David Goldstein; Madhu Singh; Iain Skinner; Ian Faragher; Matthew Croxford; Carolyn Bampton; Andrew Haydon; Ian T Jones; Christos S Karapetis; Timothy Price; Mary J Schaefer; Jeanne Ptak; Lisa Dobbyn; Natallie Silliman; Isaac Kinde; Cristian Tomasetti; Nickolas Papadopoulos; Kenneth Kinzler Journal: Gut Date: 2018-02-02 Impact factor: 23.059
Authors: Andrea Cercek; Gustavo Dos Santos Fernandes; Campbell S Roxburgh; Karuna Ganesh; Shu Ng; Francisco Sanchez-Vega; Rona Yaeger; Neil H Segal; Diane L Reidy-Lagunes; Anna M Varghese; Arnold Markowitz; Chao Wu; Bryan Szeglin; Charles-Etienne Gabriel Sauvé; Erin Salo-Mullen; Christina Tran; Zalak Patel; Asha Krishnan; Kaitlyn Tkachuk; Garrett M Nash; Jose Guillem; Philip B Paty; Jinru Shia; Nikolaus Schultz; Julio Garcia-Aguilar; Luis A Diaz; Karyn Goodman; Leonard B Saltz; Martin R Weiser; J Joshua Smith; Zsofia K Stadler Journal: Clin Cancer Res Date: 2020-03-06 Impact factor: 12.531