PMID- 34885147
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240404
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 13
IP  - 23
DP  - 2021 Nov 30
TI  - Is There a Benefit of Oxaliplatin in Combination with Neoadjuvant 
      Chemoradiotherapy for Locally Advanced Rectal Cancer? An Updated Meta-Analysis.
LID - 10.3390/cancers13236035 [doi]
LID - 6035
AB  - BACKGROUND: Neoadjuvant fluoropyrimidine (5FU or capecitabine)-based 
      chemoradiotherapy (CRT) has been considered the standard of care for locally 
      advanced rectal cancer (LARC). Whether addition of oxaliplatin (OXP) will further 
      improve clinical outcomes is still unclear. METHODS: To identify clinical trials 
      combining oxaliplatin in preoperative CRT or perioperative chemotherapy for LARC 
      published until March 2021, we searched PubMed and the Cochrane Library. We also 
      searched for relevant ASCO conference abstracts. The primary endpoint was 
      disease-free survival (DFS). Data were extracted from every study to perform a 
      meta-analysis using Review Manager (version 5.3). RESULTS: A total of seven 
      randomized clinical trials (ACCORD-12, CARO-AIO-04, FOWARC, JIAO, NSABP, 
      PETACC-6, and STAR-01) with 5782 stage II or III rectal cancer patients were 
      analyzed, including 2727 patients with OXP + 5FU regimen and 3055 patients with 
      5FU alone. Compared with the 5FU alone group, the OXP + 5FU regimen improved DFS 
      (HR = 0.90, 95% CI: 0.81-0.99, p = 0.03) and pathologic complete response (pCR) 
      (OR = 1.21, 95% CI: 1.07-1.37, p = 0.002). Patients treated with the OXP + 5FU 
      regimen had significantly less metastatic progression (OR = 0.79; 95% CI, 0.67 to 
      0.94; p = 0.007). Considering adverse events (AEs), there was more grade 3-4 
      diarrhea with OXP + 5FU (OR = 2.41, 95% CI: 1.74-3.32, p < 0.00001). However, 
      there were no significant differences grade 3-4 hematologic AEs (OR = 1.16, 95% 
      CI: 0.87-1.57, p = 0.31). CONCLUSIONS: Our meta-analysis with long-term results 
      from the randomized studies showed a benefit of the addition of OXP + 5FU 
      regiment in terms of DFS, metastatic progression, and pCR rate that did not 
      translate to improved OS.
FAU - Des Guetz, Gaetan
AU  - Des Guetz G
AD  - Medical Oncology Department, Delafontaine Hospital, 93200 St Denis, France.
AD  - Department of Surgery, Faculty of Medicine, University of Limoges, 87032 Limoges, 
      France.
FAU - Landre, Thierry
AU  - Landre T
AUID- ORCID: 0000-0003-0967-1276
AD  - Unite de Coordination en Onco-Geriatrie, Hopitaux Universitaires Paris 
      Seine-St-Denis, AP-HP, 93270 Sevran, France.
FAU - Bollet, Marc A
AU  - Bollet MA
AD  - Centre de Radiotherapie Hartmann, 92300 Levallois-Perret, France.
FAU - Mathonnet, Muriel
AU  - Mathonnet M
AUID- ORCID: 0000-0002-9127-3068
AD  - Department of Surgery, Faculty of Medicine, University of Limoges, 87032 Limoges, 
      France.
AD  - Department of Surgery, University Hospital of Limoges, 87032 Limoges, France.
FAU - Quero, Laurent
AU  - Quero L
AUID- ORCID: 0000-0002-8781-2540
AD  - INSERM U1160, Universite de Paris, 75010 Paris, France.
AD  - Radiation Oncology Department, Saint-Louis University Hospital, AP-HP, 75010 
      Paris, France.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20211130
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC8657124
OTO - NOTNLM
OT  - meta-analysis
OT  - neoadjuvant
OT  - oxaliplatin
OT  - radiotherapy
OT  - randomized
OT  - rectal
COIS- The authors declare that they have no known competing financial interest or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2021/12/11 06:00
MHDA- 2021/12/11 06:01
PMCR- 2021/11/30
CRDT- 2021/12/10 01:06
PHST- 2021/09/20 00:00 [received]
PHST- 2021/11/15 00:00 [revised]
PHST- 2021/11/26 00:00 [accepted]
PHST- 2021/12/10 01:06 [entrez]
PHST- 2021/12/11 06:00 [pubmed]
PHST- 2021/12/11 06:01 [medline]
PHST- 2021/11/30 00:00 [pmc-release]
AID - cancers13236035 [pii]
AID - cancers-13-06035 [pii]
AID - 10.3390/cancers13236035 [doi]
PST - epublish
SO  - Cancers (Basel). 2021 Nov 30;13(23):6035. doi: 10.3390/cancers13236035.