Published online Mar 27, 2021. doi: 10.4240/wjgs.v13.i3.267
Peer-review started: October 9, 2020
First decision: December 8, 2020
Revised: December 13, 2020
Accepted: January 15, 2021
Article in press: January 15, 2021
Published online: March 27, 2021
Neoadjuvant therapy (NAT) is becoming the standard way to treat locally advanced rectal cancer (LARC). Radiation has been an important part of NAT. More research on preoperative radiation is warranted.
To explore what kind of impact preoperative radiation has on tumor downstaging, postoperative complications, and survival in LARC. To provide more evidence for choosing a NAT regimen.
To compare the downstaging effect, postoperative complications, and prognosis between two different NAT regimens: The combination of radiation and chemotherapy and chemotherapy alone.
We retrospectively collected and analyzed the data of the two different regimens of NAT. The χ2 test was used to compare the downstaging effect, postoperative complications, etc. Kaplan-Meier analysis was used to describe and compare survival.
The study found that the primary tumor regression effect was better with the combination of radiation and chemotherapy than chemotherapy alone. This agrees with many previous articles. There were no significant differences in postoperative complications between the two groups, while overall survival was better in the radiochemotherapy group. However, no article comparing survival in LARC with or without radiation before surgery has been carried out. This waits to be confirmed by further studies.
This study tried to compare two different NAT regimens in LARC. Preoperative radiation may contribute to radical surgery in LARC and improve the prognosis as well.
A prospective study comparing postoperative complications and survival in NAT with or without preoperative radiation waits to be carried out.