Review Article

Systematic Review: Adjuvant Chemotherapy for Locally Advanced Rectal Cancer with respect to Stage of Disease

Table 1

Main characteristics of included studies.

ā€‰ Glimelius et al. 2005 [11]CCCSGJ 1995 [12]Fisher et al.
1988 [13]
Kato et al.
2002 [14]
Kodaira et al.
1998 [15]
Hamaguchi et al. 2011 [16]QUASAR 2007 [17]Sakamoto et al. 2007 [18]

Study designMulticentre RCTMulticentre RCTMulticentre RCTMulticentre RCTMulticentre RCTMulticentre RCTMulticentre RCTPatient based meta-analysis of multicentre RCTs

Number of patients 2224200155528983460632392091

Stage of rectal cancerII and IIIII and IIIII and IIIII and IIIII and IIIIIIII and IIIII and III

Intervention arm(s)Surgery
adjuvant CT
Arm 1:
surgery
adjuvant intra-arterial + systemic CT
arm 2:
surgery
adjuvant CT
Arm 1:
surgery
adjuvant CT
arm 2:
surgery
adjuvant RD
Surgery
adjuvant CT
Surgery
adjuvant CT
Surgery
adjuvant CT
Surgery
adjuvant CT
Surgery
adjuvant CT

Control armSurgerySurgerySurgerySurgerySurgerySurgerySurgerySurgery

Chemotherapy regimenArm 1:
5FU + levamisole
arm 2:
5FU + leucovorin
arm 3:
5FU + leucovorin + levamisole
Arm 1:
MMC + 5FU
arm 2:
MMC + 5FU
5-FU + semustine + vincristineUFTMMC + UFTUFT5-FU +
L-folinic acid
UFT

Intention to treat analysisYesNot reportedNot reportedNot reportedNot reportedNot reportedYesNot reported

OutcomesOSDSF and OSDSF and OSDSF and OSDSF and OSDSF and OSDSF and OSDSF and OS

Risk of biasLowLowLowLowLowLowLowLow
(except reporting bias)

Methodological qualityHighHighHighHighHighHighHighHigh

CT: chemotherapy, RCT: randomised controlled trial, RD: radiotherapy, 5-FU: 5-fluorouracil, MMC: mitomycin C, UFT: Tegafur-uracil, OS: overall survival, and DSF: disease-free survival,ā€‰based on SIGN notes on methodology checklist.