Comparison of 5-FU-based and Capecitabine-based Neoadjuvant Chemoradiotherapy in Patients With Rectal Cancer: A Meta-analysis.

INTRODUCTION: The inconvenience of using infusion therapies resulted in the development of capecitabine (CA), an oral fluoropyrimidine. In this meta-analysis, we evaluated 10 studies that compared the efficacy and safety of an oral CA-based regimen with those of a continuous infusion 5-fluorouracil (5-FU) regimen for neoadjuvant chemoradiotherapy in patients with rectal cancer. MATERIALS AND METHODS: The databases searched included Medline, Cochrane, EMBASE, and Google Scholar (until August 31, 2016). The primary outcome assessed was the rate of postoperative down-staging of the tumor and pathologic complete response. The secondary outcomes were disease-free survival (DFS) and overall survival (OS). RESULTS: This meta-analysis (5 retrospective studies, 3 prospective studies, and 2 randomized controlled trials [RCTs]) compared the efficacy of the 5-FU arm (n = 757) to that of the CA arm (n = 719). There was no significant difference in tumor down-staging rate between the 2 regimens (RCTs/prospective studies: odds ratio [OR], 0.88; 95% confidence interval [CI], 0.65-1.20; P = .416; retrospective studies: OR, 0.84; 95% CI, 0.50-1.44; P = .534). There was also no significant difference in pathologic complete response (RCTs/prospective studies: OR, 0.80; 95% CI, 0.52-1.23; P = .304; retrospective studies: OR, 0.73; 95% CI, 0.48-1.12; P = .149), or survival rates (3-year, 5-year DFS, and 5-year OS rate) between the 2 groups. The CA group had a higher number of patients reporting diarrhea and hand-foot syndrome compared with the 5-FU group. The 5-FU group had a higher number of patients reporting mucositis compared with the CA group. CONCLUSIONS: Our data suggested that oral CA was equivalent to continuous infusion 5-FU in the curative setting of rectal cancer during neoadjuvant chemoradiotherapy.

[Clinicopathological features and prognosis of colorectal cancer patients with preoperative cancer-related anemia].

OBJECTIVE: To analyze the clinicopathological features and prognosis of colorectal cancer patients with preoperative cancer-related anemia. METHODS: Clinical data of 354 patients with colorectal cancer in the Second Affiliated Hospital of Guangzhou Medical College from January 2003 to July 2009 were analyzed retrospectively. Those with hemoglobin(Hb)<120 g/L before surgery were defined as cancer-related anemia. RESULTS: Of the 354 colorectal cancer cases, 195 were males and 159 were females. The median age was 65(range 22-92) years. Preoperative cancer-related anemia tended to be occurred in female(P<0.01) and those with preoperative albumin ≤35 g/L (P<0.01), right colon cancer(P<0.01) and full-thickness invasion(P<0.05). Cox regression analysis showed preoperative cancer-related anemia was an independent unfavorable factor for overall survival (HR=1.60, 95% CI:1.05-2.44; P<0.05), but not for disease-free survival (HR=1.43, 95% CI:0.97-2.12; P>0.05) in colorectal cancer. CONCLUSIONS: Preoperative cancer-related anemia plays an important role in the development and prognosis of colorectal cancer and great attention should be paid to clinical practice.