Postoperative chemotherapy in patients with rectal cancer receiving preoperative radio(chemo)therapy: A meta-analysis of randomized trials comparing surgery +/- a fluoropyrimidine and surgery plus a fluoropyrimidine +/- oxaliplatin

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Bujko, K. (författare)

Postoperative chemotherapy in patients with rectal cancer receiving preoperative radio(chemo)therapy : A meta-analysis of randomized trials comparing surgery +/- a fluoropyrimidine and surgery plus a fluoropyrimidine +/- oxaliplatin

Artikel/kapitelEngelska2015

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Elsevier BV,2015
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-257472
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-257472URI
https://doi.org/10.1016/j.ejso.2015.03.233DOI

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Språk:engelska
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Background: There is no consensus on the role of postoperative chemotherapy in patients with rectal cancer who have received preoperative radio(chemo)therapy. Materials and methods: A systematic review and meta-analysis were performed of trials that used preoperative radio(chemo)therapy and randomized patients either between postoperative chemotherapy and observation or between a fluoropyrimidine only (FU-only) and a fluoropyrimidine with oxaliplatin (FU-OXA) as postoperative chemotherapy. Results: Five randomized studies compared postoperative chemotherapy with observation in a total of 2398 patients. None of these trials demonstrated a statistically significant benefit of chemotherapy for OS and DFS. The pooled differences in OS and DFS did not differ statistically significantly between the chemotherapy group and the observation group. The hazard ratios (HRs) and 95% confidence intervals (CIs) were 0.95 (CI: 0.82-1.10), P = 0.49 and 0.92 (CI: 0.80-1.04), P = 0.19, respectively. In the subgroup of trials in which randomization was performed after surgery (n = 753), a statistically significant positive pooled chemotherapy effect was observed for DFS (HR = 0.79, 95% CI: 0.62-1.00, P = 0.047), but not for OS (P = 0.39). Four randomized trials compared adjuvant FU OXA with adjuvant FU-only in 2710 patients. In two trials, the difference in DFS between groups was statistically significant in favour of FU OXA, and in the other two trials, the difference was not significant. The pooled difference in DFS between the FU OXA group and the FU-only group was not statistically significant: HR = 0.84 (CI: 0.66-1.06), P = 0.15. Conclusion: The use of postoperative chemotherapy in patients with rectal cancer receiving preoperative radio(chemo)therapy is not based on strong scientific evidence. (C) 2015 Elsevier Ltd. All rights reserved.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
Rectal cancer
Adjuvant chemotherapy
Oxaliplatin-combination

Biuppslag (personer, institutioner, konferenser, titlar ...)

Glimelius, BengtUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)bengglim (författare)
Valentini, V. (författare)
Michalski, W. (författare)
Spalek, M. (författare)
Uppsala universitetExperimentell och klinisk onkologi (creator_code:org_t)

Sammanhörande titlar

Ingår i:European Journal of Surgical Oncology: Elsevier BV41:6, s. 713-7230748-79831532-2157

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European Journal of Surgical Oncology (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Bujko, K.; Glimelius, Bengt; Valentini, V.; Michalski, W.; Spalek, M.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

Artiklar i publikationen: European Journal ...

Av lärosätet: Uppsala universitet

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