Efficacy of Short-Term Versus Long-Term Radiotherapy in Rectal Cancer: A Frisbee-Based Meta-Analysis (A Friendly Evidence-Based Review of The Literature)

Abstract

Gustavo Gomez Barbieri*, Giovanni Petracca and Antonella Capomolla

Introduction Rectal cancer is the second most common cancer in Italy, with nearly 50,000 cases expected by 2024. Given the high cost and quality of life for its families, its mortality rate is low, ranging from 5 to 7% in the early stages too high in the advanced stages, with a mortality rate of 90%.

Methods A search was conducted in Epistemonikos, the largest database of systematic reviews in the healthcare field, maintained by screening multiple sources of information, including MEDLINE, EMBASE, and Cochrane, among others. Data were extracted from the identified reviews, data from the primary studies were analyzed, a meta-analysis was performed, and a summary table of the results was prepared using the GRADE method.

Results and Conclusions Six systematic reviews were identified, which together include thirty-seven primary studies, of which 37 correspond to randomized trials. It was concluded that the use of short-term IMRT plus immediate chemotherapy compared to neoadjuvant chemotherapy, surgery, and radiotherapy increases local control and disease-free survival and reduces complications and the need for surgery compared to long-term radiotherapy, with a high degree of evidence.

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