3542 - To Explore the Efficacy and Safety of Neoadjuvant Chemoradiotherapy in Locally Advanced Colon Cancer: A Systematic Review and Meta-Analysis
Presenter(s)
J. Sun, and F. P. Wu; The fourth hospital of hebei medical university, Shijiazhuang, Hebei, China
Purpose/Objective(s): The aim of this study was to systematically evaluate the efficacy and safety of neoadjuvant chemoradiotherapy (nCRT) in locally advanced colon cancer (LACC).
Materials/Methods: PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov databases were searched to review relevant studies on nCRT for LACC published publicly from January 2000 to October 2024. Literatures were screened according to the inclusion and exclusion criteria, quality assessment was performed on those that met the criteria, and meta-analysis and sensitivity analysis were performed using Stata 15.0 software after extracting relevant data.
Results: Eleven studies with a total of 698 LACC patients treated with nCRT were finally included in the analysis. Meta-analysis revealed that, in terms of surgical resection, patients achieved an R0 resection rate of 92% (95% CI: 88%-96%). Pertaining to the tumor regression, the pathological complete response (pCR) rate was 20% (95% CI: 16%-25%), the major pathological response (MPR) rate was 50% (95% CI: 36%-64%). In the aspect of organ preservation, the overall organ preservation rate was 53% (95% CI: 46%-60%), while the rate for patients with bladder involvement reached 87% (95% CI: 73%-100%). Regarding postoperative recurrence or metastasis, patients had a local recurrence rate of 10% (95% CI: 6%-13%) and a distant metastasis rate of 21% (95% CI: 14%-27%). Compared with no neoadjuvant radiotherapy, neoadjuvant radiotherapy improved 5-year overall survival (OS) in LACC patients (HR=1.42, 95% CI: 1.1-1.82). With respect to safety, the incidence of grade =3 adverse reactions after nCRT was 14% (95% CI: 9%-19%), with gastrointestinal reactions accounting for 6% (95% CI: 3%-9%) and postoperative anastomotic fistula occurring in 3% (95% CI: 0%-5%).
Conclusion: This meta-analysis demonstrated that nCRT has shown good efficacy in LACC with manageable and controllable toxic side effects.