Bin Ma1, Peng Gao1, Yongxi Song1, Xuanzhang Huang2, Hongchi Wang1, Qingzhou Xu1, Shan Zhao1, Zhenning Wang3. 1. Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Shenyang, People's Republic of China. 2. Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Shenyang, People's Republic of China; Department of Chemotherapy and Radiotherapy, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City, People's Republic of China. 3. Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Shenyang, People's Republic of China. Electronic address: josieon826@sina.cn.
Abstract
BACKGROUND: To assess whether preoperative short-course radiotherapy (PSRT) could be the treatment of choice compared to preoperative long-course chemoradiotherapy (PLCRT) METHODS: The PubMed, Embase, and Web of Science Databases were searched to conduct a systematic review and meta-analysis. Perioperative and survival outcomes between PSRT and PLCRT were selected as end points for our meta-analysis. In addition, health-related quality-of-life outcomes were also systematically reviewed between PSRT and PLCRT. Finally, we also reviewed evidence of optimized regimens of PSRT (with delayed surgery or adding consolidation chemotherapy). RESULTS: PLCRT showed a better pathologic complete response (pCR) rate (odds ratio = 0.05, 95% confidence interval = 0.02-0.18, P < .01), but this benefit did not translate into a higher sphincter preservation rate (odds ratio = 1.62, 95% confidence interval = 0.72-3.67, P = .25) or other perioperative outcome differences. In terms of survival outcomes, adding either PLCRT or PSRT both showed obvious advantages for local control compared to surgery alone, and PSRT and PLCRT had similar long-term outcomes irrespective of pairwise or network meta-analyses. Moreover, on the basis of health-related quality-of-life scores, PSRT and PLCRT also had no overall differences. Systematic review of current evidence indicates that the insufficiency of PSRT on pCR might be improved by delayed surgery or adding consolidation chemotherapy. CONCLUSIONS: PSRT could be the treatment of choice compared to PLCRT when pCR is not the primary aim. PSRT with delayed surgery or adding consolidation may provide further possibilities for the future evolution of neoadjuvant therapies.
BACKGROUND: To assess whether preoperative short-course radiotherapy (PSRT) could be the treatment of choice compared to preoperative long-course chemoradiotherapy (PLCRT) METHODS: The PubMed, Embase, and Web of Science Databases were searched to conduct a systematic review and meta-analysis. Perioperative and survival outcomes between PSRT and PLCRT were selected as end points for our meta-analysis. In addition, health-related quality-of-life outcomes were also systematically reviewed between PSRT and PLCRT. Finally, we also reviewed evidence of optimized regimens of PSRT (with delayed surgery or adding consolidation chemotherapy). RESULTS: PLCRT showed a better pathologic complete response (pCR) rate (odds ratio = 0.05, 95% confidence interval = 0.02-0.18, P < .01), but this benefit did not translate into a higher sphincter preservation rate (odds ratio = 1.62, 95% confidence interval = 0.72-3.67, P = .25) or other perioperative outcome differences. In terms of survival outcomes, adding either PLCRT or PSRT both showed obvious advantages for local control compared to surgery alone, and PSRT and PLCRT had similar long-term outcomes irrespective of pairwise or network meta-analyses. Moreover, on the basis of health-related quality-of-life scores, PSRT and PLCRT also had no overall differences. Systematic review of current evidence indicates that the insufficiency of PSRT on pCR might be improved by delayed surgery or adding consolidation chemotherapy. CONCLUSIONS: PSRT could be the treatment of choice compared to PLCRT when pCR is not the primary aim. PSRT with delayed surgery or adding consolidation may provide further possibilities for the future evolution of neoadjuvant therapies.
Authors: Wang Qiaoli; Huang Yongping; Xiong Wei; Xu Guoqiang; Ju Yunhe; Liu Qiuyan; Li Cheng; Guo Mengling; Li Jiayi; Xiong Wei; Yang Yi Journal: Int J Colorectal Dis Date: 2019-11-19 Impact factor: 2.571
Authors: Santiago Avila; George J Chang; N Arvind Dasari; Danyal A Smani; Prajnan Das; Joeseph M Herman; Eugene Koay; Albert Koong; Sunil Krishnan; Bruce D Minsky; Grace L Smith; Cullen Taniguchi; Melissa W Taggart; Harmeet Kaur; Emma B Holliday Journal: Clin Colorectal Cancer Date: 2020-02-08 Impact factor: 4.481
Authors: Mauro Podda; Patricia Sylla; Gianluca Baiocchi; Michel Adamina; Vanni Agnoletti; Ferdinando Agresta; Luca Ansaloni; Alberto Arezzo; Nicola Avenia; Walter Biffl; Antonio Biondi; Simona Bui; Fabio C Campanile; Paolo Carcoforo; Claudia Commisso; Antonio Crucitti; Nicola De'Angelis; Gian Luigi De'Angelis; Massimo De Filippo; Belinda De Simone; Salomone Di Saverio; Giorgio Ercolani; Gustavo P Fraga; Francesco Gabrielli; Federica Gaiani; Mario Guerrieri; Angelo Guttadauro; Yoram Kluger; Ari K Leppaniemi; Andrea Loffredo; Tiziana Meschi; Ernest E Moore; Monica Ortenzi; Francesco Pata; Dario Parini; Adolfo Pisanu; Gilberto Poggioli; Andrea Polistena; Alessandro Puzziello; Fabio Rondelli; Massimo Sartelli; Neil Smart; Michael E Sugrue; Patricia Tejedor; Marco Vacante; Federico Coccolini; Justin Davies; Fausto Catena Journal: World J Emerg Surg Date: 2021-07-02 Impact factor: 5.469
Authors: Jiahua Lyu; Tao Liu; Tao Li; Fang Li; Qifeng Wang; Jie Wang; Yongtao Han; Junchao Wang; Jun Zhang; Lin Peng; Jinyi Lang Journal: Cancer Med Date: 2019-05-22 Impact factor: 4.452
Authors: Agastya Patel; Piotr Spychalski; Giulia Corrao; Barbara A Jereczek-Fossa; Robert Glynne-Jones; Julio Garcia-Aguilar; Jarek Kobiela Journal: Acta Oncol Date: 2021-07-24 Impact factor: 4.311