title: Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis.
abstract: A meta-analysis was carried out to compare the efficacy and safety of capecitabine plus radiation with 5-fluorouracil (5-FU) plus radiotherapy (RT) as neoadjuvant treatment in locally advanced rectal cancer (LARC). We searched the Cochrane database, Ovid, Medline, Embase, ISI databases, and Chinese Biomedical Literature Database between January 1998 and October 2014. Trials of capecitabine compared with 5-FU plus RT as neoadjuvant treatment for LARC were considered for inclusion. RevMan software was used to analyze these data. Nine trials were included in this meta-analysis, which covered a total of 3141 patients. The meta-analysis showed that capecitabine group had statistically significant better pCR rates (OR, 1.34; 95% CI, 1.10-1.64;P= 0.003), T downstaging rates (OR, 1.58; 95% CI, 1.22-2.06;P= 0.0007), N downstaging rates (OR, 2.06; 95% CI, 1.34-3.16;P= 0.001), less distant metastasis (OR, 0.63; 95% CI, 0.44-0.88;P= 0.007), and lowered leucocytes (OR, 0.25; 95% CI, 0.11-0.54;P= 0.0005), but with higher incidence of hand-foot syndrome (HFS) (OR, 4.43; 95% CI, 1.59-12.33;P= 0.004). Capecitabine was more efficient than 5-FU in terms of tumor response in neoadjuvant treatment for patients with LARC and favourably low toxicity with the exception of HFS.
authors.affiliation: Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong 510060, China.
authors.forename: Guo-Chen
authors.identifier: 0000-0002-7857-9089
authors.initials: GC
authors.lastname: Liu
authors.affiliation: Department of Laboratory Medicine, Guangdong No. 2 Provincial People's Hospital, Guangdong, China.
authors.forename: Jun-Ping
authors.initials: JP
authors.lastname: Yan
authors.affiliation: Department of General Surgery, People's Hospital of Yuxi City, Yunnan, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: He
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong, China.
authors.forename: Xin
authors.identifier: 0000-0002-4603-0059
authors.initials: X
authors.lastname: An
authors.affiliation: Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong 510060, China.
authors.forename: Zhi-Zhong
authors.identifier: 0000-0003-0612-7435
authors.initials: ZZ
authors.lastname: Pan
authors.affiliation: Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong 510060, China.
authors.forename: Pei-Rong
authors.identifier: 0000-0003-1067-2639
authors.initials: PR
authors.lastname: Ding