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29.08.2019 | Review Article

Assessing the Effect of Radiotherapy in Addition to Surgery in Colon Adenocarcinomas: a Systematic Review and Meta-analysis of Contemporary Evidence

verfasst von: Ryan Anthony F. Agas, Lester Bryan A. Co, Paolo G. Sogono, JC Kennetth M. Jacinto, Kelvin Ken L. Yu, Luisa E. Jacomina, Warren R. Bacorro, Teresa T. Sy Ortin

Erschienen in: Journal of Gastrointestinal Cancer | Ausgabe 2/2020

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Abstract

Purpose

This study aims to review the contemporary evidence investigating radiotherapy (RT) in addition to surgery for colon adenocarcinomas.

Methods

We searched the following databases: PubMed, Science Direct, Scopus, ASCOpubs, the Cochrane Library, and Google Scholar. Studies (since January 2005) comparing outcomes of high-risk colon adenocarcinomas who underwent RT in addition to surgery versus no RT were eligible. Pooling of outcomes from published results or from analysis of survival curves was done. Subgroup analysis was conducted to determine if the efficacy of RT varies with RT timing.

Results

Eight studies were included (five retrospective cohorts, three population-based studies). Pooled analysis from retrospective cohorts showed a reduction in 5-year LR (OR 0.41; 95% CI 0.21–0.79; p = 0.007) in the RT group. A benefit in 3-year (OR 1.81; 95% CI 1.15–2.87; p = 0.01) and 5-year (OR 2.10; 95% CI 1.21–3.63; p = 0.008) DFS and in 3-year (OR 2.55; 95% CI 1.43–4.54; p = 0.001) and 5-year (OR 2.00; 95% CI 1.17–3.41; p = 0.01) OS was seen in the RT group. The OS benefit was demonstrated in the subgroup analysis of neoadjuvant RT, but not with adjuvant RT. The improvement in OS with neoadjuvant RT was supported by a population-based study from NCDB, while results from two population-based studies investigating adjuvant RT were conflicting.

Conclusion

Taking into account the limitations of the studies, our review of evidence suggests a possible role of RT in improving oncologic outcomes of select colon adenocarcinomas. Prospective studies are needed to definitively assess the value of RT for colon cancer.

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Titel: Assessing the Effect of Radiotherapy in Addition to Surgery in Colon Adenocarcinomas: a Systematic Review and Meta-analysis of Contemporary Evidence
verfasst von: Ryan Anthony F. Agas
Lester Bryan A. Co
Paolo G. Sogono
JC Kennetth M. Jacinto
Kelvin Ken L. Yu
Luisa E. Jacomina
Warren R. Bacorro
Teresa T. Sy Ortin
Publikationsdatum: 29.08.2019
Verlag: Springer US
Erschienen in: Journal of Gastrointestinal Cancer / Ausgabe 2/2020
Print ISSN: 1941-6628
Elektronische ISSN: 1941-6636
DOI: https://doi.org/10.1007/s12029-019-00300-2

Springer Medizin

Assessing the Effect of Radiotherapy in Addition to Surgery in Colon Adenocarcinomas: a Systematic Review and Meta-analysis of Contemporary Evidence