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Role of oxaliplatin in preoperative of advanced rectal cancer: a metaanalysis#br#

  

  1. 1.Department of Gastroenterology,the Affiliated Nanhua Hospital of University of South China,
    Hengyang 421002, China; 2.Department of Breast Oncology, Sun YatSen University
    Cancer Center, Guangzhou 510000, China
  • Online:2017-01-05 Published:2017-01-12
  • Contact: Corresponding author: Wu Qing, Email: nhwuqing@163.com

Abstract: ObjectiveTo explore the role of oxaliplatin combined with capecitabine in the preoperative of advanced rectal cancer. MethodsA comprehensive search of literatures including Pubmed, Embase, China National Knowledge Infrastructure, Wanfang database and Vip database was performed. The metaanalysis included randomized controlled trial to compare neoadjuvant capecitabine plus radiation with or without oxaliplatin with respect to complete response and toxicities. ResultsOf 735 reports, four randomized controlled trials including  2 066 patients were identified by two reviewers. There was no statistically significant differences between capecitabine plus radiation with or without oxaliplatin in ypCR (P=0.13). The CAPOX (radiation+capecitabine+oxaliplatin) group increased with 13% in the toxicity (95%CI=0.080.18,P<0.01),increased with 9% in diarrhea(95%CI=0.060.12,P<0.01)  and increased with 4% in fatigue (95%CI=0.020.06,P=0.0002)  in comparison with the CAP (radiation+oxaliplatin). No significant difference was observed in radiation dermatitis and handfoot syndrome. ConclusionOxaliplatin does not improve the ypCR but increase considerable toxicities. Current evidence supports preoperative radiation plus capecitabine in the treatment of patients with rectal cancer, but still needs more highquality clinical trials.

Key words: stomach neoplasms, capecitabine, oxaliplatin;chemoradiotherapy