Adjuvant Second-Dose Chemotherapy before Surgery for Patients with Locally Advanced Rectal Malignancy Is Not Beneficial: A Systematic Review and Meta-Analysis

Table 1

Characteristics of studies included in the meta-analysis.

Study

Year

Country

Additional CT regimen

CT regimen in CRT

CT before or after CRT

Boost RT

Total radiation (Gy)

Surgery

Group

Interval^# (weeks)

N (M/F)

Age (years)

cT stage

cTXN+

T2

T3

T4

Fernández-Martos; et al. [16]

2010

Spain

CAPOX; 4 cycles

CAPOX

Before

No

50.4

TME

CT + CRT

5-6

56 (39/17)

60 (38–76)

18

7

31

CRT

5-6

52 (34/18)

62 (42–75)

17

3

31

Marechal et al. [30]

2012

Belgium

FOLFOX6 (1); 2 cycles

5-FU

Before

No

45

TME

CT + CRT

6–8

28 (21/7)

62 (22–80)

1

25

2

26

CRT

6–8

29 (16/13)

62 (44–79)

3

23

3

25

Moore et al. [31]

2014

Australia

5FU + leucovorin; 3 cycles

5-FU

After

NR

50.4

NR

CT + CRT

10

20

NA

NA

NA

NA

NA

CRT

10

20

NA

NA

NA

NA

NA

Calvo et al. [32]

2006

Spain

FOLFOX4; 2 cycles

Tegafur

Before

Yes

≥50.4

Safety distal margin distance or TME

CT + CRT

4–6

52 (38/14)

69 (37–80)

4

43

5

24

CRT

4–6

62 (43/19)

66 (26–82)

2

53

7

27

Garcia-Aguilar et al. [33]

2015

USA

FOLFOX6 (2); 2 cycles

5-FU

After

Yes

≥50.4

TME

CT + CRT

11.1

67 (37/30)

56 (32–84)

6

60

1

55

CRT

8.5

60 (37/23)

57 (34–87)

2

57

1

40

Note: CAPOX, capecitabine 2000 mg/m² 14/21 days and oxaliplatin 130 mg/m² 1/21 days; FOLFOX6 (1), oxaliplatin 100 mg/m² 1/14 days, folinic acid 400 mg/m² 1/14 days, 5-FU 400 mg/m² 1/14 days, and 5-FU 2000 mg/m² CVI over 46 h/14 days. FOLFOX4, oxaliplatin 85 mg/m² 1/14 days, folinic acid 200 mg/m² 1-2/14 days, 5-FU 400 mg/m² 1/14 days, and 5-FU 600 mg/m² CVI in 22 h/14 days. FOLFOX6 (2), oxaliplatin 85 mg/m² 1/14 days, folinic acid 400 or 200 mg/m² 1/14 days, 5-FU 400 mg/m² 1/14 days, and 5-FU 2400 mg/m² CVI over 46 h/14 days. ^#Interval between surgery and CRT. CT, chemotherapy; CRT, chemoradiotherapy; RT, radiotherapy; TME, total mesorectal excision; N, patient number; M, male; F, female; NA, not available.