Comparative efficacy and safety of preoperative treatments for locally advanced rectal cancer: a network meta-analysis

5^th Annual Congress on Gastroenterology & Hepatology

August 20-21, 2021 | Webinar

Yao Ye

The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310009, China

Scientific Tracks Abstracts: cgj

Abstract :

The preoperative chemoradiation are the standard treatments for locally advanced rectal cancer (LARC). However, the efficacy and safety of different strategies remain controversial. Direct comparisons of them in the same study are absent at present. The aim of our study was to provide comprehensive assessment on this issue. Therefore, PUBMED and EMBASE were searched up to December 2020 and estimated 6500 patients enrolled in 20 different RCTs, with 27 studies comparing 6 different regimens for preoperative treatment of LARC were included. And the 6 regimens were summarized as follow: short-course radiotherapy (SCRT), short-course radiotherapy with delayed surgery (SCRT-D), regular radiotherapy (RT), RT/fluorouracil (RT+FU), RT/fluorouracil/oxalipaltin (RT+FU+Oxali), RT/fluorouracil/irinotecan (RT+FU+IRI). Event numbers for pathologic complete response (pCR), survival effects and adverse events were estimated. Moreover, surface under the cumulative ranking (SUCRA) values were adopted to rank of these different regimens. SCRT-D and RT could get better complete response in contrast with SCRT. Fluorouracil-based preoperative chemoradiotherapy and the addition of oxaliplatin or irinotecan could achieve significantly superior pathologic complete response compared with RT, SCRT or SCRT-D alone. However, only addition of irinotecan to fluorouracil-based preoperative chemoradiotherapy could provide a marginally better survival effect compared with other regimens. Moreover, the adverse events of this regimen were acceptable compared with single fluorouracil-based preoperative chemoradiotherapy. In addition, it is apprehensible that RT or SCRT alone was associated with the least toxic effects. In conclusion, the addition of irinotecan could provide marginal survival advantages over first-line single fluorouracil-based chemoradiotherapy with acceptable adverse events and it merits further clinical trials to evaluate its efficacy and safety.

Biography :

Yao Ye has completed his MD at the age of 26 years from Zhejiang University and postdoctoral studies from Zhejiang University School of Medicine. He is a colorectal surgeon in the Second Affiliated Hospital of Zhejiang University. He has published 8 papers in gastrointestinal oncology field.