Adjuvant Chemotherapy in Rectal Cancer after Chemoradiotherapy.

Fiche publication

Date publication

février 2016

Journal

Clinical oncology (Royal College of Radiologists (Great Britain))

Auteurs

Membres identifiés du Cancéropôle Est :
Dr BOUSTANI Jihane

Tous les auteurs :
Boustani J, Caubet M, Bosset JF

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/26698026

Résumé

The aim of this overview was to investigate whether adjuvant chemotherapy has a favourable effect on the outcome of patients with rectal cancer who had preoperative (chemo)radiotherapy. A review of randomised clinical trials that allocated patients between fluorouracil-based and observation or between fluorouracil-based and oxaliplatin-based adjuvant chemotherapy after preoperative (chemo)radiotherapy was carried out, including their corresponding meta-analyses. None of the five randomised trials has shown a significant benefit of fluorouracil-based adjuvant chemotherapy for overall survival or disease-free survival. Also, the three corresponding meta-analyses failed to show a benefit of adjuvant treatment. Of three randomised trials - two phase III and one phase II with a 3-year disease-free survival end point - two showed a small benefit of adding oxaliplatin to fluorouracil, one failed. The corresponding meta-analyses showed that the pooled difference was not significant. In conclusion, the use of postoperative 5-fluorouracil-based chemotherapy with or without oxaliplatin in patients with rectal cancer after preoperative (chemo)radiotherapy is not scientifically proven.