Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.

<h4>Background and purpose</h4>The role of preoperative short-course radiotherapy (SCRT) in rectal cancer treatment, when compared to long-course radiochemotherapy (LCRT), is still controversial. Thus the meta-analysis with trial sequential analysis (TSA) was performed to evaluate the lo...

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Main Authors: Xin Wang, Bobo Zheng, Xinlan Lu, Ruhai Bai, Linlin Feng, Quan Wang, Yan Zhao, Shuixiang He
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0200142&type=printable
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author Xin Wang
Bobo Zheng
Xinlan Lu
Ruhai Bai
Linlin Feng
Quan Wang
Yan Zhao
Shuixiang He
author_facet Xin Wang
Bobo Zheng
Xinlan Lu
Ruhai Bai
Linlin Feng
Quan Wang
Yan Zhao
Shuixiang He
author_sort Xin Wang
collection DOAJ
description <h4>Background and purpose</h4>The role of preoperative short-course radiotherapy (SCRT) in rectal cancer treatment, when compared to long-course radiochemotherapy (LCRT), is still controversial. Thus the meta-analysis with trial sequential analysis (TSA) was performed to evaluate the long-term survival of SCRT and LCRT as therapeutic regimens for locally advanced rectal cancer.<h4>Material and methods</h4>PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to August 2017 for eligible studies. Hazard ratios (HRs) or odds ratios (ORs) of overall survival (OS), disease free survival (DFS) and local recurrence (LR) with the corresponding 95% confidence intervals (CIs) were calculated and TSA was applied.<h4>Results</h4>11 studies with 1984 patients were included. There was no significant difference in OS (HR = 0.92, 95% CI: 0.75-1.13, p = 0.44), DFS (HR = 0.94, 95% CI: 0.79-1.12, p = 0.50) and LR (OR = 0.73, 95% CI: 0.49-1.08, p = 0.11) between SCRT and LCRT groups. TSA suggested firm evidence for lacking on average a -10% relative risk reduction (RRR) in 4-year OS but no statistical significance in 4-year DFS.<h4>Conclusions</h4>Preoperative SCRT is as effective as LCRT for locally advanced colorectal cancer in long-term survival. SCRT could be preferential while facing long waiting lists or lacking medical resource.
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spelling doaj-art-d8c63634fbb14b81b9e07e165bdbbb0f2025-08-20T02:45:55ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01137e020014210.1371/journal.pone.0200142Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.Xin WangBobo ZhengXinlan LuRuhai BaiLinlin FengQuan WangYan ZhaoShuixiang He<h4>Background and purpose</h4>The role of preoperative short-course radiotherapy (SCRT) in rectal cancer treatment, when compared to long-course radiochemotherapy (LCRT), is still controversial. Thus the meta-analysis with trial sequential analysis (TSA) was performed to evaluate the long-term survival of SCRT and LCRT as therapeutic regimens for locally advanced rectal cancer.<h4>Material and methods</h4>PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to August 2017 for eligible studies. Hazard ratios (HRs) or odds ratios (ORs) of overall survival (OS), disease free survival (DFS) and local recurrence (LR) with the corresponding 95% confidence intervals (CIs) were calculated and TSA was applied.<h4>Results</h4>11 studies with 1984 patients were included. There was no significant difference in OS (HR = 0.92, 95% CI: 0.75-1.13, p = 0.44), DFS (HR = 0.94, 95% CI: 0.79-1.12, p = 0.50) and LR (OR = 0.73, 95% CI: 0.49-1.08, p = 0.11) between SCRT and LCRT groups. TSA suggested firm evidence for lacking on average a -10% relative risk reduction (RRR) in 4-year OS but no statistical significance in 4-year DFS.<h4>Conclusions</h4>Preoperative SCRT is as effective as LCRT for locally advanced colorectal cancer in long-term survival. SCRT could be preferential while facing long waiting lists or lacking medical resource.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0200142&type=printable
spellingShingle Xin Wang
Bobo Zheng
Xinlan Lu
Ruhai Bai
Linlin Feng
Quan Wang
Yan Zhao
Shuixiang He
Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.
PLoS ONE
title Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.
title_full Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.
title_fullStr Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.
title_full_unstemmed Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.
title_short Preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer: Meta-analysis with trial sequential analysis of long-term survival data.
title_sort preoperative short course radiotherapy and long course radiochemotherapy for locally advanced rectal cancer meta analysis with trial sequential analysis of long term survival data
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0200142&type=printable
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