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Gastroenterology Research and Practice
Volume 2016, Article ID 1798285, 10 pages
http://dx.doi.org/10.1155/2016/1798285
Review Article

Effect of Neoadjuvant Chemoradiotherapy with Capecitabine versus Fluorouracil for Locally Advanced Rectal Cancer: A Meta-Analysis

1Department 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
2Department of Laboratory Medicine, Guangdong No. 2 Provincial People’s Hospital, Guangdong, China
3Department of General Surgery, People’s Hospital of Yuxi City, Yunnan, China
4Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong, China
5Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong 510060, China

Received 2 April 2016; Accepted 30 June 2016

Academic Editor: Carlos Fernandez-Martos

Copyright © 2016 Guo-Chen Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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; ), T downstaging rates (OR, 1.58; 95% CI, 1.22–2.06; ), N downstaging rates (OR, 2.06; 95% CI, 1.34–3.16; ), less distant metastasis (OR, 0.63; 95% CI, 0.44–0.88; ), and lowered leucocytes (OR, 0.25; 95% CI, 0.11–0.54; ), but with higher incidence of hand-foot syndrome (HFS) (OR, 4.43; 95% CI, 1.59–12.33; ). 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.