Short-course Preoperative Radiotherapy With Immediate Surgery Versus Long-course Chemoradiation With Delayed Surgery In The Treatment Of Rectal Cancer:A Meta-analysis

Objective:Short-course radiotherapy（SCRT）with immediate surgery and Long-course chemoradiotherapy（LCRT）with delayed surgery both are very important regimen in the treatment of rectal cancer at present.This meta-analysis was performed to compare the advantages and disadvantages in terms of surgery,survival and adverse reactions of short-and long-course preoperative treatments.Methods:Literature including randomized controlled studies and clinical studies,were screened and extracted from Cochrane Library,PubMed,Embase,China National Knowledge Infrastructure（CNKI）,wanfang database with regard to SCRT with immediate surgery or LCRT with delayed surgery In strict accordance with the inclusion and exclusion criteri.Literature quality assessment and Meta analysis were conducted by the RevMan 5.3 software.Results:Ten studies were included in the end,and Among them,there are five randomized controlled trial literatures.The meta-analysis suggested that R₀ resection rate（OR=0.45,95%CI为0.24～0.82,P=0.009）,T stage decreased（OR=0.44,95%CI为0.29～0.68,P<0.001）,pCR rate（OR=0.07,95%CI为0.03～0.17,P<0.05）of LCRT group were significantly higher than SCRT group,It’s more dominant in LCRT group about Grade 1-4 acute toxicity（OR=0.05,95%CI为0.00～0.77,P=0.03）and Grade 3-4acute toxicity（OR=0.07,95%CI为0.03～0.15,P<0.05）.There were no significant differences in sphincter preservation rate,local recurrence rate（LRR）,distant metastasis rate（DMR）,disease free survival rate（DFS）,overall survivalOS),late toxicity and postoperative complications（P>0.05）.Conclusion:Long-course chemoradiotherapy（LCRT）with delayed surgery raised the T stage decreased,R₀ resection rate and pCR compared to short-course radiotherapy（SCRT）with immediate surgery,but It also increases early acute toxicity.Fuether there was no significant difference in the overall postoperative complications.