Cargando…
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...
Autores principales: | , , , |
---|---|
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 |
_version_ | 1784844946022334464 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9727153 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT luowenhao isneoadjuvantchemoradiotherapyforpancreaticcancerbeneficialasystematicreviewandmetaanalysis AT wangyawen isneoadjuvantchemoradiotherapyforpancreaticcancerbeneficialasystematicreviewandmetaanalysis AT taoyinjie isneoadjuvantchemoradiotherapyforpancreaticcancerbeneficialasystematicreviewandmetaanalysis AT zhangtaiping isneoadjuvantchemoradiotherapyforpancreaticcancerbeneficialasystematicreviewandmetaanalysis |