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Total neoadjuvant therapy versus standard therapy in locally advanced rectal cancer: A systematic review and meta-analysis of 15 trials

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  • Xiping Zhang
  • Shujie Ma
  • Yinyin Guo
  • Yang Luo
  • Laiyuan Li

Abstract

Background: Neoadjuvant chemoradiotherapy (nCRT) before total mesorectal excision (TME) and followed systemic chemotherapy is widely accepted as the standard therapy for locally advanced rectal cancer (LARC). This meta-analysis was to evaluate the current evidence regarding nCRT in combination with induction or consolidation chemotherapy for rectal cancer in terms of oncological outcomes. Methods: A systematic search of medical databases (PubMed, EMBASE and Cochrane Library) was conducted up to the end of July 1, 2021. This meta-analysis was performed to evaluate the efficacy of TNT in terms of pathological complete remission (pCR), nCRT or surgical complications, R0 resection, local recurrence, distant metastasis, disease-free survival (DFS) and overall survival (OS) in LARC. Results: Eight nRCTs and 7 RCTs, including 3579 patients were included in the meta-analysis. The rate of pCR was significantly higher in the TNT group than in the nCRT group, (OR 1.85, 95% CI 1.39–2.46, p

Suggested Citation

  • Xiping Zhang & Shujie Ma & Yinyin Guo & Yang Luo & Laiyuan Li, 2022. "Total neoadjuvant therapy versus standard therapy in locally advanced rectal cancer: A systematic review and meta-analysis of 15 trials," PLOS ONE, Public Library of Science, vol. 17(11), pages 1-13, November.
    • Handle: RePEc:plo:pone00:0276599
    DOI: 10.1371/journal.pone.0276599
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