Early versus delayed surgery after short-course radiotherapy for rectal cancer: A network meta-analysis of randomized Controlled Trials

作者：Yan‐Jiun Huang, Chi Tai, Yi‐No Kang, Po‐Li Wei · 发表于：Asian Journal of Surgery · 年份：2019 · DOI：10.1016/j.asjsur.2019.10.006 · 被引用次数：2 · 研究领域：Colorectal Cancer Surgical Treatments、Colorectal and Anal Carcinomas、Advances in Oncology and Radiotherapy

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...