Scolaris Content Display Scolaris Content Display

Forest plot of comparison: 1 Primary Outcome Parameters, outcome: 1.1 Overall Survival.
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Figure 1

Forest plot of comparison: 1 Primary Outcome Parameters, outcome: 1.1 Overall Survival.

Forest plot of comparison: 1 Primary outcome: 1.2 Local Recurrence CRT versus RT.Due to potential interaction identified by the Bosset study authors this analysis does not include participants who underwent post‐operative chemotherapy.
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Figure 2

Forest plot of comparison: 1 Primary outcome: 1.2 Local Recurrence CRT versus RT.

Due to potential interaction identified by the Bosset study authors this analysis does not include participants who underwent post‐operative chemotherapy.

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.1 30 Day Mortality CRT versus RT.
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Figure 3

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.1 30 Day Mortality CRT versus RT.

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.2 Sphincter Preservation CRT versus RT.
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Figure 4

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.2 Sphincter Preservation CRT versus RT.

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.3 Acute Toxicity CRT versus RT.
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Figure 5

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.3 Acute Toxicity CRT versus RT.

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.4 Late Toxicity CRT versus RT.
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Figure 6

Forest plot of comparison: 2 Secondary Outcome Parameters, outcome: 2.4 Late Toxicity CRT versus RT.

Comparison 1 Primary Outcome Parameters, Outcome 1 Overall Survival.
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Analysis 1.1

Comparison 1 Primary Outcome Parameters, Outcome 1 Overall Survival.

Comparison 1 Primary Outcome Parameters, Outcome 2 Local Recurrence.
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Analysis 1.2

Comparison 1 Primary Outcome Parameters, Outcome 2 Local Recurrence.

Comparison 2 Secondary Outcome Parameters, Outcome 1 30 Day Mortality.
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Analysis 2.1

Comparison 2 Secondary Outcome Parameters, Outcome 1 30 Day Mortality.

Comparison 2 Secondary Outcome Parameters, Outcome 2 Sphincter Preservation.
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Analysis 2.2

Comparison 2 Secondary Outcome Parameters, Outcome 2 Sphincter Preservation.

Comparison 2 Secondary Outcome Parameters, Outcome 3 Acute Toxicity.
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Analysis 2.3

Comparison 2 Secondary Outcome Parameters, Outcome 3 Acute Toxicity.

Comparison 2 Secondary Outcome Parameters, Outcome 4 Late Toxicity.
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Analysis 2.4

Comparison 2 Secondary Outcome Parameters, Outcome 4 Late Toxicity.

Table 1. TNM classification of rectal cancer.

Tumour

T1

Tumour invades submucosa.

T2

Tumour invades muscularis propria.

T3

Tumour invades through to subserosa or into perirectal tissues.

T4

Tumour invades into surrounding structures/organs.

Nodes

N0

no lymph nodes involved.

N1

1‐3 local lymph nodes involved.

N2

>4 lymph nodes involved.

Metastases

M0

no distant metastases.

M1

Distant metastases.

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Table 1. TNM classification of rectal cancer.
Table 2. Staging of rectal cancer.

Stage

Dukes classification

5 year survival (%)

T1‐2N0M0

I

A

80

T3N0M0

IIA

B

40‐60

T4N0M0

IIB

B

40‐60

T1‐2N1M0

IIIA

C

40

T3‐4N1M0

IIIB

C

30

TanyN2M0

IIIC

C

12

TanyNanyM1

IV

D

15 (2 year survival)

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Table 2. Staging of rectal cancer.
Table 3. Toxicity; Outcome measures and results

Study

Outcome Measure(s)

CRT

RT

Bujko 2006

Toxicity was measured using the Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer (EORTC) scale grade III‐IV.

Toxicity was classified as late toxicity if it occurred more than 30 days after surgery.

18.2%

3.2%

Ngan 2007

One or more adverse early event. Published in abstract form so limited information currently available.

28%

1.9%

Gerard 2006

Early grade III‐IV toxicity, assessed using the WHO scale.

14.6%

2.7%

Bosset 2004

Patients enrolled before January 2001, n=798

Grade II toxicity assessed using the WHO acute morbidity scale or the occurrence of acute diarrhoea.

34.3%

17.3%

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Table 3. Toxicity; Outcome measures and results
Comparison 1. Primary Outcome Parameters

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Overall Survival Show forest plot

4

2312

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.85, 1.20]

2 Local Recurrence Show forest plot

5

2138

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.42, 0.75]

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Comparison 1. Primary Outcome Parameters
Comparison 2. Secondary Outcome Parameters

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 30 Day Mortality Show forest plot

3

1568

Odds Ratio (M‐H, Fixed, 95% CI)

1.73 [0.88, 3.38]

2 Sphincter Preservation Show forest plot

4

2148

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.86, 1.20]

3 Acute Toxicity Show forest plot

4

2178

Odds Ratio (M‐H, Fixed, 95% CI)

3.96 [3.03, 5.17]

4 Late Toxicity Show forest plot

2

638

Odds Ratio (M‐H, Fixed, 95% CI)

0.88 [0.50, 1.54]

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Comparison 2. Secondary Outcome Parameters