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Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis

To examine the potential benefits and adverse events of neoadjuvant Chemoradiotherapy (CRT) versus upfront surgery in pancreatic cancer (PC) patients. Extensive librarian-led literature searches were conducted on PubMed, Web-of-Science, Scopus, Google Scholar, the Cochrane Central Library and Embase...

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Autores principales: Luo, Wenhao, Wang, Yawen, Tao, Yinjie, Zhang, Taiping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9727153/
https://www.ncbi.nlm.nih.gov/pubmed/36505795
http://dx.doi.org/10.3389/fonc.2022.979390
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author Luo, Wenhao
Wang, Yawen
Tao, Yinjie
Zhang, Taiping
author_facet Luo, Wenhao
Wang, Yawen
Tao, Yinjie
Zhang, Taiping
author_sort Luo, Wenhao
collection PubMed
description To examine the potential benefits and adverse events of neoadjuvant Chemoradiotherapy (CRT) versus upfront surgery in pancreatic cancer (PC) patients. Extensive librarian-led literature searches were conducted on PubMed, Web-of-Science, Scopus, Google Scholar, the Cochrane Central Library and Embase. The primary outcomes were resectability, adverse events, pathological and survival outcomes. Five studies, including 437 participants, were analyzed. Upfront surgery had a significantly higher resectability among PC patients than neoadjuvant CRT group (Odds ratio = -0.11, 95% CI = -0.19–0.02, P = 0.01). The neoadjuvant CRT group had a comparatively higher Ro resection rate (OR = 3.38, 95% CI = 2.03–5.62, P < 0.01), fewer severe adverse events(OR = 0.56, 95% CI = 0.34–0.92, P = 0.02), lower positive LN rate(OR = 0.18, 95% CI = 0.11-0.31, P < 0.01) and higher 2-year OS(OR = 1.60, 95% CI = 1.02-2.52, P = 0.04) among PC patients than control group. There was no significant difference between neoadjuvant CRT and upfront surgery among PC patients on postoperative complications(OR = 1.49, 95% CI = 0.86-2.57, P = 0.16), metastasis rate(OR = 1.32, 95% CI = 0.42-4.18, P = 0.64) and 1-year OS(OR = 1.30, 95% CI = 0.85-1.98, P = 0.22). This systematic review confirmed the status of neoadjuvant CRT in the PC treatment. The neoadjuvant CRT could increase the R0 resection rate, which was important to the survival and life quality of patients. The specific choice of various neoadjuvant CRT therapy needs to be further studied. Individualized neoadjuvant therapy should be suitable for each patient, and patients with PC are best managed by a multidisciplinary team.
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spelling pubmed-97271532022-12-08 Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis Luo, Wenhao Wang, Yawen Tao, Yinjie Zhang, Taiping Front Oncol Oncology To examine the potential benefits and adverse events of neoadjuvant Chemoradiotherapy (CRT) versus upfront surgery in pancreatic cancer (PC) patients. Extensive librarian-led literature searches were conducted on PubMed, Web-of-Science, Scopus, Google Scholar, the Cochrane Central Library and Embase. The primary outcomes were resectability, adverse events, pathological and survival outcomes. Five studies, including 437 participants, were analyzed. Upfront surgery had a significantly higher resectability among PC patients than neoadjuvant CRT group (Odds ratio = -0.11, 95% CI = -0.19–0.02, P = 0.01). The neoadjuvant CRT group had a comparatively higher Ro resection rate (OR = 3.38, 95% CI = 2.03–5.62, P < 0.01), fewer severe adverse events(OR = 0.56, 95% CI = 0.34–0.92, P = 0.02), lower positive LN rate(OR = 0.18, 95% CI = 0.11-0.31, P < 0.01) and higher 2-year OS(OR = 1.60, 95% CI = 1.02-2.52, P = 0.04) among PC patients than control group. There was no significant difference between neoadjuvant CRT and upfront surgery among PC patients on postoperative complications(OR = 1.49, 95% CI = 0.86-2.57, P = 0.16), metastasis rate(OR = 1.32, 95% CI = 0.42-4.18, P = 0.64) and 1-year OS(OR = 1.30, 95% CI = 0.85-1.98, P = 0.22). This systematic review confirmed the status of neoadjuvant CRT in the PC treatment. The neoadjuvant CRT could increase the R0 resection rate, which was important to the survival and life quality of patients. The specific choice of various neoadjuvant CRT therapy needs to be further studied. Individualized neoadjuvant therapy should be suitable for each patient, and patients with PC are best managed by a multidisciplinary team. Frontiers Media S.A. 2022-11-23 /pmc/articles/PMC9727153/ /pubmed/36505795 http://dx.doi.org/10.3389/fonc.2022.979390 Text en Copyright © 2022 Luo, Wang, Tao and Zhang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Luo, Wenhao
Wang, Yawen
Tao, Yinjie
Zhang, Taiping
Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis
title Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis
title_full Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis
title_fullStr Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis
title_full_unstemmed Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis
title_short Is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: A systematic review and meta-analysis
title_sort is neoadjuvant chemoradiotherapy for pancreatic cancer beneficial: a systematic review and meta-analysis
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9727153/
https://www.ncbi.nlm.nih.gov/pubmed/36505795
http://dx.doi.org/10.3389/fonc.2022.979390
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