■新辅助放化疗已成为局部晚期直肠癌的既定治疗方法。然而,对于在新辅助放化疗和手术后表现出良好肿瘤反应(ypT0-2N0)的局部晚期直肠癌患者,是否需要辅助化疗仍存在争议.因此,本研究的目的是探讨对新辅助放化疗反应良好的直肠癌患者,辅助化疗对肿瘤预后的影响。
■本研究按照系统评价和荟萃分析方案的首选报告项目进行。文章在WebofScience上搜索,PubMed,和Cochrane图书馆数据库。评估的主要结果是5年总生存率,无病生存,癌症特异性生存率,无复发生存率,局部复发,和远处转移。使用随机效应模型总结数据。
■使用2009年至2023年之间发表的18项回顾性研究进行了荟萃分析。这些研究包括9项来自中国和5项来自韩国,共有6566例接受新辅助放化疗后的ypT0-2N0直肠癌患者。汇总数据显示,辅助化疗显著改善5年总生存率(OR=1.75,95%CI:1.15-2.65,P=0.008)。无复发生存率(OR=1.73,95%CI:1.20-2.48,P=0.003),远处转移减少(OR=0.68,95%CI:0.51-0.92,P=0.011)。然而,辅助化疗对无病生存率没有显著影响,癌症特异性生存率,ypT0-2N0直肠癌的局部复发。亚组分析表明,辅助化疗有利于改善ypT1-2N0直肠癌的总生存期(OR=1.89,95%CI:1.13-3.19,P=0.003)。
■荟萃分析的结果表明,在新辅助放化疗和根治性手术后,apT0-2N0的直肠癌患者的肿瘤预后方面,辅助化疗可能会带来益处。然而,需要进一步的前瞻性临床研究来证实这些发现.
UNASSIGNED: Neoadjuvant chemoradiotherapy has emerged as the established treatment for locally advanced rectal cancer. Nevertheless, there remains a debate regarding the necessity of adjuvant chemotherapy for patients with locally advanced rectal cancer who exhibit a favorable tumor response (ypT0-2N0) after neoadjuvant chemoradiotherapy and surgery. Thus, the objective of this study is to investigate the impact of adjuvant chemotherapy on the oncological prognosis of rectal cancer patients who have a good response to neoadjuvant chemoradiotherapy.
UNASSIGNED: The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles were searched in the Web of Science, PubMed, and Cochrane Library databases. The primary outcomes assessed were 5-year overall survival, disease-free survival, cancer-specific survival, recurrence-free survival, local recurrence, and distant metastasis. The data was summarized using a random effects model.
UNASSIGNED: A meta-analysis was conducted using 18 retrospective studies published between 2009 and 2023. The studies included 9 from
China and 5 from Korea, involving a total of 6566 patients with ypT0-2N0 rectal cancer after neoadjuvant chemoradiotherapy. The pooled data revealed that adjuvant chemotherapy significantly improved 5-year overall survival (OR=1.75, 95% CI: 1.15-2.65, P=0.008), recurrence-free survival (OR=1.73, 95% CI: 1.20-2.48, P=0.003), and reduced distant metastasis (OR=0.68, 95% CI: 0.51-0.92, P=0.011). However, adjuvant chemotherapy did not have a significant effect on disease-free survival, cancer-specific survival, and local recurrence in ypT0-2N0 rectal cancer. Subgroup analysis indicated that adjuvant chemotherapy was beneficial in improving overall survival for ypT1-2N0 rectal cancer (OR=1.89, 95% CI: 1.13-3.19, P=0.003).
UNASSIGNED: The findings of the meta-analysis suggest that adjuvant chemotherapy may provide benefits in terms of oncological outcomes for rectal cancer patients with ypT0-2N0 after neoadjuvant chemoradiotherapy and radical surgery. However, further prospective clinical studies are needed to confirm these findings.