Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis

A meta-analysis was carried out to compare the efficacy and safety of capecitabine plus radiation with 5-fluorouracil (5-FU) plus radiotherapy (RT) as neoadjuvant treatment in locally advanced rectal cancer (LARC). We searched the Cochrane database, Ovid, Medline, Embase, ISI databases, and Chinese...

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Main Authors: Guo-Chen Liu, Jun-Ping Yan, Qing He, Xin An, Zhi-Zhong Pan, Pei-Rong Ding
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2016/1798285
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author Guo-Chen Liu
Jun-Ping Yan
Qing He
Xin An
Zhi-Zhong Pan
Pei-Rong Ding
author_facet Guo-Chen Liu
Jun-Ping Yan
Qing He
Xin An
Zhi-Zhong Pan
Pei-Rong Ding
author_sort Guo-Chen Liu
collection DOAJ
description A meta-analysis was carried out to compare the efficacy and safety of capecitabine plus radiation with 5-fluorouracil (5-FU) plus radiotherapy (RT) as neoadjuvant treatment in locally advanced rectal cancer (LARC). We searched the Cochrane database, Ovid, Medline, Embase, ISI databases, and Chinese Biomedical Literature Database between January 1998 and October 2014. Trials of capecitabine compared with 5-FU plus RT as neoadjuvant treatment for LARC were considered for inclusion. RevMan software was used to analyze these data. Nine trials were included in this meta-analysis, which covered a total of 3141 patients. The meta-analysis showed that capecitabine group had statistically significant better pCR rates (OR, 1.34; 95% CI, 1.10–1.64; P=0.003), T downstaging rates (OR, 1.58; 95% CI, 1.22–2.06; P=0.0007), N downstaging rates (OR, 2.06; 95% CI, 1.34–3.16; P=0.001), less distant metastasis (OR, 0.63; 95% CI, 0.44–0.88; P=0.007), and lowered leucocytes (OR, 0.25; 95% CI, 0.11–0.54; P=0.0005), but with higher incidence of hand-foot syndrome (HFS) (OR, 4.43; 95% CI, 1.59–12.33; P=0.004). Capecitabine was more efficient than 5-FU in terms of tumor response in neoadjuvant treatment for patients with LARC and favourably low toxicity with the exception of HFS.
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spelling doaj-art-bb9fa0cf26d4494699ffb8ac616f21cd2025-08-20T02:18:43ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/17982851798285Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-AnalysisGuo-Chen Liu0Jun-Ping Yan1Qing He2Xin An3Zhi-Zhong Pan4Pei-Rong Ding5Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong 510060, ChinaDepartment of Laboratory Medicine, Guangdong No. 2 Provincial People’s Hospital, Guangdong, ChinaDepartment of General Surgery, People’s Hospital of Yuxi City, Yunnan, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong, ChinaDepartment of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong 510060, ChinaDepartment of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong 510060, ChinaA meta-analysis was carried out to compare the efficacy and safety of capecitabine plus radiation with 5-fluorouracil (5-FU) plus radiotherapy (RT) as neoadjuvant treatment in locally advanced rectal cancer (LARC). We searched the Cochrane database, Ovid, Medline, Embase, ISI databases, and Chinese Biomedical Literature Database between January 1998 and October 2014. Trials of capecitabine compared with 5-FU plus RT as neoadjuvant treatment for LARC were considered for inclusion. RevMan software was used to analyze these data. Nine trials were included in this meta-analysis, which covered a total of 3141 patients. The meta-analysis showed that capecitabine group had statistically significant better pCR rates (OR, 1.34; 95% CI, 1.10–1.64; P=0.003), T downstaging rates (OR, 1.58; 95% CI, 1.22–2.06; P=0.0007), N downstaging rates (OR, 2.06; 95% CI, 1.34–3.16; P=0.001), less distant metastasis (OR, 0.63; 95% CI, 0.44–0.88; P=0.007), and lowered leucocytes (OR, 0.25; 95% CI, 0.11–0.54; P=0.0005), but with higher incidence of hand-foot syndrome (HFS) (OR, 4.43; 95% CI, 1.59–12.33; P=0.004). Capecitabine was more efficient than 5-FU in terms of tumor response in neoadjuvant treatment for patients with LARC and favourably low toxicity with the exception of HFS.http://dx.doi.org/10.1155/2016/1798285
spellingShingle Guo-Chen Liu
Jun-Ping Yan
Qing He
Xin An
Zhi-Zhong Pan
Pei-Rong Ding
Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis
Gastroenterology Research and Practice
title Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis
title_full Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis
title_fullStr Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis
title_full_unstemmed Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis
title_short Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis
title_sort effect of neoadjuvant chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer a meta analysis
url http://dx.doi.org/10.1155/2016/1798285
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