PMID- 35117848
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220501
IS  - 2219-6803 (Electronic)
IS  - 2218-676X (Print)
IS  - 2218-676X (Linking)
VI  - 9
IP  - 8
DP  - 2020 Aug
TI  - Comparison of different chemoradiotherapy regimens for the preoperative treatment 
      in patients with locally advanced rectal cancer: a network meta-analysis.
PG  - 4857-4869
LID - 10.21037/tcr-20-683 [doi]
AB  - BACKGROUND: The efficacy of different neoadjuvant chemoradiotherapy regimens on 
      locally advanced rectal cancer (LARC) remains confusing. We evaluated them 
      together via a network meta-analysis in terms of survival benefits to find the 
      optimal treatment. METHODS: We searched, EMBASE, Cochrane Central Register of 
      Controlled Trials and the ClinicalTrials website according to the selection 
      criteria for eligible publications before Oct 25, 2019. Pathological complete 
      response rate (pCR), disease-free survival (DFS), and overall survival (OS) were 
      analyzed based on Bayesian methods in the meta-analysis. RESULTS: Twenty-five 
      articles containing 7,142 participants and 12 preoperative regimens were 
      analyzed. In terms of pCR, radiation therapy plus 5-fluorouracil (RT+5-Fu), RT 
      plus capecitabine (RT+CAPE), RT plus 5-fluorouracil and oxaliplatin (RT+FOLFOX), 
      RT plus capecitabine and oxaliplatin (RT+XELOX), and RT plus S-1 and irinotecan 
      (RT+IS) were better than RT alone [odds ratio (OR) =2.66, 95% credible interval 
      [CrI], 1.38-5.01; OR =3.11, 95% CrI: 1.33-6.98; OR =4.03, 95% CrI: 1.77-9.47; OR 
      =4.22, 95% CrI: 1.60-10.87; OR =4.55, 95% CrI: 1.11-18.88, respectively] and 
      RT+FOLFOX and RT+XELOX were superior to FOLFOX (OR =4.58, 95% CrI: 1.57-14.19; OR 
      =4.81, 95% CrI: 1.20-18.73), too. Benefits could be seen on comparing RT+CAPE, 
      RT+FOLFOX, and RT+XELOX with RT (OR =0.84, 95% CrI: 0.73-0.97; OR =0.88, 95% CrI: 
      0.80-0.97; OR =0.79, 95% CrI: 0.66-0.95, respectively) in DFS. RT+XELOX seemed to 
      have better effects on OS compared than RT+5-Fu and RT+CAPE (OR =0.78, 95% CrI: 
      0.61-1.00; OR =0.86, 95% CrI: 0.74-1.00, respectively). Moreover, according to 
      surface under the cumulative ranking curve analysis, RT+XELOX had the best 
      outcomes in terms of pCR (79.18%) and OS (83.49%) and RT plus capecitabine, 
      irinotecan, and cetuximab (RT+XELIRI+CET) ranked first with respect to DFS 
      (87.86%). CONCLUSIONS: RT+XELOX is likely to be the best treatment with a 
      comprehensive curative effect and the standard treatment of 5-fluorouracil-based 
      chemoradiotherapy has some advantages, as well. More relevant evidence is needed 
      for clinicians' guidance.
CI  - 2020 Translational Cancer Research. All rights reserved.
FAU - Yu, Zhengyi
AU  - Yu Z
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Wang, Jiawei
AU  - Wang J
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Xu, Lingyan
AU  - Xu L
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Liu, Jin
AU  - Liu J
AD  - Clinical Medicine Research Institution, The First Affiliated Hospital of Nanjing 
      Medical University, Nanjing, China.
FAU - Chen, Xiaofeng
AU  - Chen X
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Gu, Yanhong
AU  - Gu Y
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Transl Cancer Res
JT  - Translational cancer research
JID - 101585958
PMC - PMC8798459
OTO - NOTNLM
OT  - Chemoradiotherapy
OT  - locally advanced rectal cancer (LARC)
OT  - neoadjuvant treatment
OT  - network meta-analysis
OT  - preoperative treatment
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/tcr-20-683). The authors have no 
      conflicts of interest to declare.
EDAT- 2020/08/01 00:00
MHDA- 2020/08/01 00:01
PMCR- 2020/08/01
CRDT- 2022/02/04 05:52
PHST- 2020/01/19 00:00 [received]
PHST- 2020/06/23 00:00 [accepted]
PHST- 2022/02/04 05:52 [entrez]
PHST- 2020/08/01 00:00 [pubmed]
PHST- 2020/08/01 00:01 [medline]
PHST- 2020/08/01 00:00 [pmc-release]
AID - tcr-09-08-4857 [pii]
AID - 10.21037/tcr-20-683 [doi]
PST - ppublish
SO  - Transl Cancer Res. 2020 Aug;9(8):4857-4869. doi: 10.21037/tcr-20-683.