Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials

摘要: BACKGROUND: At least 28 randomised, controlled trials have compared outcomes of surgery for rectal cancer combined with preoperative or postoperative radiotherapy those alone. We done a collaborative meta-analysis these results to give more balanced view the total evidence and increase statistical precision. METHODS: centrally checked analysed individual patient data from 22 randomised comparisons between (6,350 patients in 14 trials) (2157 eight no cancer. FINDINGS: Overall survival was only marginally better who were allocated than alone (62% vs 63% died; p=0.06). Rates apparently curative resection not improved by (85% 86% control). Yearly risk local recurrence 46% (SE 6) lower had (p=0.00001), 37% (10) treatment (p=0.002). Fewer died did (45% 50%, respectively, p=0.0003), but early (/=30 Gy) reduces death cancer. If safety can be without compromising effectiveness, then overall would moderately use radiotherapy, especially young, high patients. Postoperative also recurrence, short radiation schedules seem at as longer schedules.