Efficacy Of Aspirin As An Adjuvant Aget During Neoadjuvant Chemoradiotherapy For Rectal Cancer :A Meta-analysis

Objective To systematically evaluate the efficacy of aspirin as a adjuvant agent during neoadjuvant chemoradiotherapy for rectal cancer.Methods Databases,including PubMed,EMbase,OVID,the Cochrane Library,CNKI and Wanfangdata,were searched from inception to October2018 to obtain relevant literatures about aspirin-use in neoadjuvant chemoradiotherapy for rectal cancer.Use RevMan 5.3 software for meta-analysis.Results Four trials that fit the criteria were included,involving 638 patients.The complete remission rate of patients in the study group was 22.5%,higher than 15.1% in the control group,with statistically significant difference(P=0.03,RR=1.49,95% CI 1.04-2.14).The partial remission rate of patients in the study group was 45.7%,significantly higher than 21.8% in the control group,with statistically significant difference(P=0.002,RR=1.94,95%CI 1.28-2.93).The tumor downstaging rate of patients in the study group was 63.8%,significantly higher than that of the control group(44.4%),with statistically significantdifference(P=0.0003,RR=1.45,95% CI 1.19-1.77).The 3-year survival rate and 5-year survival rate in the study group were higher than those in the control group.The local recurrence rate of patients in the study group was5.7%,significantly lower than the 21.6% in the control group,with statistically significant difference(P=0.02,RR=0.37,95% CI0.17-0.84).Conclusion Aspirin can improve complete remission rate,partial remission rate,tumor downstaging rate,3-year survival rate,5-year survival rate and reduce local tumor recurrence rate in patients with rectal cancer receiving neoadjuvant chemoradiotherapy and it is expected to become a new adjuvant drug in neoadjuvant chemoradiotherapy of rectal cancer.