TY - JOUR
T1 - Early versus delayed surgery after short-course radiotherapy for rectal cancer
T2 - A network meta-analysis of randomized Controlled Trials
AU - Huang, Yan Jiun
AU - Tai, Chi
AU - Kang, Yi No
AU - Wei, Po Li
N1 - Publisher Copyright:
© 2019
PY - 2020/8
Y1 - 2020/8
N2 - Objective: To evaluate the optimal timing of surgery after short-course radiation therapy and to compare the efficacy of short-course radiotherapy (SCRT) and long-course radiotherapy (LCRT) in patients with rectal cancer, a systematic review with network analysis was conducted. Methods: A systematic literature search of the Cochrane Central Register of Controlled Trials, Embase, and MEDLINE (PubMed) was conducted to identify papers published before June 4, 2018, without language or publication date restrictions. The use of surface under the cumulative ranking curve (SUCRA) within a network meta-analysis framework provided a numerical presentation of the overall ranking, thus providing a ranking of treatment options from which patients can choose from. Within the primary search that yielded 1435 studies, 11 relevant randomized trials were identified. Results: No statistically significant difference was found in overall mortality and metastasis between short-course radiotherapy with early surgery (SCES), short-course radiotherapy with delayed surgery (SCDS), and long-course radiotherapy with delayed surgery (LCDS). For overall metastasis, using SUCRA analysis, SCES, LCDS, and SCDS respectively had the highest to lowest SUCRA rank, respectively. Thus, SCES was the most likely to be effective, followed by LCDS and SCDS. Conclusion: Regarding the optimal timing of surgery for patients with advanced rectal cancer undergoing short-course radiation therapy, SCES is recommended as the optimal choice according to the available evidence and considering the control of future metastasis.
AB - Objective: To evaluate the optimal timing of surgery after short-course radiation therapy and to compare the efficacy of short-course radiotherapy (SCRT) and long-course radiotherapy (LCRT) in patients with rectal cancer, a systematic review with network analysis was conducted. Methods: A systematic literature search of the Cochrane Central Register of Controlled Trials, Embase, and MEDLINE (PubMed) was conducted to identify papers published before June 4, 2018, without language or publication date restrictions. The use of surface under the cumulative ranking curve (SUCRA) within a network meta-analysis framework provided a numerical presentation of the overall ranking, thus providing a ranking of treatment options from which patients can choose from. Within the primary search that yielded 1435 studies, 11 relevant randomized trials were identified. Results: No statistically significant difference was found in overall mortality and metastasis between short-course radiotherapy with early surgery (SCES), short-course radiotherapy with delayed surgery (SCDS), and long-course radiotherapy with delayed surgery (LCDS). For overall metastasis, using SUCRA analysis, SCES, LCDS, and SCDS respectively had the highest to lowest SUCRA rank, respectively. Thus, SCES was the most likely to be effective, followed by LCDS and SCDS. Conclusion: Regarding the optimal timing of surgery for patients with advanced rectal cancer undergoing short-course radiation therapy, SCES is recommended as the optimal choice according to the available evidence and considering the control of future metastasis.
KW - Meta-analysis
KW - Rectal cancer
KW - Short-course radiation therapy
KW - Surgery
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U2 - 10.1016/j.asjsur.2019.10.006
DO - 10.1016/j.asjsur.2019.10.006
M3 - Article
AN - SCOPUS:85075436997
SN - 1015-9584
VL - 43
SP - 810
EP - 818
JO - Asian Journal of Surgery
JF - Asian Journal of Surgery
IS - 8
ER -
