Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Meta-analysis of the influence of time interval between radical operation and preoperative chemoradiotherapy on complete pathological response in rectal cancer patients

Liangjie Zheng¹, Weibo Hu¹, Xue Zhen¹, Yanxia Yang²

¹Department of Oncology, The Peopleâ€™s Hospital of Leling City; ²Pharmacy of Traditional Chinese Medicine, Leling Hospital of Traditional Chinese Medicine, Leling 253600, Shandong Province, China.

For correspondence:- Yanxia Yang Email: yangyanxia1106@126.com

Accepted: 22 August 2018 Published: 30 September 2018

Citation: Zheng L, Hu W, Zhen X, Yang Y. Meta-analysis of the influence of time interval between radical operation and preoperative chemoradiotherapy on complete pathological response in rectal cancer patients. Trop J Pharm Res 2018; 17(9):1859-1865 doi: 10.4314/tjpr.v17i9.26

© 2018 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To evaluate the impact of interval between chemoradiotherapy (CRT) and surgery on rates of pathological complete response (pCR).

Methods: A search was carried out from PubMed and Embase databases for literature related to clinical benefits in rectal cancer patients after surgery performed at different intervals following neoadjuvant therapy. The main endpoint was the rate of pCR. Relative risk (RR) of chance of a pCR among different intervals was assessed.

Results: Among 3462 screened individuals, 11 retrospective cohort studies representing 3462 relevant patients were qualified for inclusion in the study. The time intervals varied between ≤ 5 weeks and > 12 weeks. Thell studies were divided into 6 categories based on surgical timing. The potential association between the pCR rate and time intervals of 5, 6, 7, 8, 10 or 12 weeks was analyzed. Pooled RR and 95 % confidence intervals (CIs) of pCR rates at different intervals were plotted on a line chart. The highest plateau in the RR of pCR rates were noted in patients undergoing surgery beyond 7 weeks (RR, 1.60; 95 % CI, 1.20 – 2.13; p = 0.001) after the end of CRT.

Conclusion: Radical operation over 7 weeks following CRT results in the highest risk of pCR. The question as to whether this is associated with high long-term survival rate remains to be resolved.

Keywords: Rectal cancer, Time interval, Surgery, Chemotherapy, Radiotherapy