Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis  

作　　者：Ying Wang Yan Yang Qi-Qi Liu Shao-Zhao Wang 

机构地区：[1]Department of Anus Intestinal Surgery,Feicheng People’s Hospital,Feicheng 271600,Shandong Province,China [2]Department of Gastroenterology,Qingdao Hospital of University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital),Qingdao 266011,Shandong Province,China [3]Department of Gastrointestinal Surgery,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong Province,China [4]Department of Anorectal Words,Central Hospital Affiliated Shandong First Medical University,Jinan 250013,Shandong Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第6期1845-1856,共12页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND To compare the efficacy and safety of total neoadjuvant therapy(TNT)and neoadjuvant chemoradiotherapy(nCRT)in the treatment of middle and low locally advanced rectal cancer.Our study will systematically collect and integrate studies to evaluate the ability of these two treatments to improve tumor shrinkage rates,surgical resection rates,tumor-free survival,and severe adverse events.AIM To provide clinicians and patients with more reliable treatment options to optimize treatment outcomes and quality of life for patients with locally advanced rectal cancer by comparing the advantages and disadvantages of the two treatment options.METHODS A full search of all clinical studies on the effectiveness and safety of TNT and nCRT for treating locally advanced rectal cancer identified in Chinese(CNKI,Wanfang,China Biomedical Literature Database)and English(PubMed,Embase)databases was performed.Two system assessors independently screened the studies according to the inclusion and exclusion criteria.Quality evaluation and RESULTS Finally,14 studies were included,six of which were randomized controlled studies.A total of 3797 patients were included,including 1865 in the TNT group and 1932 in the nCRT group.The two sets of baseline data were comparable.The results of the meta-analysis showed that the pCR rate[odds ratio(OR)=1.57,95%confidence interval(CI):1.30-1.90,P<0.00001],T stage degradation rate(OR=2.16,95%CI:1.63-2.57,P<0.00001),and R0 resection rate(OR=1.42,95%CI:1.09-1.85,P=0.009)were significantly greater in the nCRT group than in the nCRT group.There was no significant difference in the incidence of grade 3/4 acute toxicity or perioperative complications between the two groups.The 5-year OS[hazard ratio(HR)=0.84,95%CI:0.69-1.02,P=0.08]and DFS(HR=0.94,95%CI:0.03-1.39,P=0.74)of the TNT group were similar to those of the nCRT group.CONCLUSION TNT has greater clinical efficacy and safety than nCRT in the treatment of locally advanced rectal cancer.

关 键 词：Neoadjuvant therapy Neoadjuvant chemoradiotherapy Advanced rectal cancer Clinical efficacy META-ANALYSIS 

分 类 号：R730.5[医药卫生—肿瘤]