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A meta-analysis was carried out to compare the efficacy and safety of capecitabine plus radiation with 5-fluorouracil (5-FU) plus radiotherapy (RT) as neoadjuvant treatment in locally advanced rectal cancer (LARC). We searched the Cochrane database, Ovid, Medline, Embase, ISI databases, and Chinese Biomedical Literature Database between January 1998 and October 2014. Trials of capecitabine compared with 5-FU plus RT as neoadjuvant treatment for LARC were considered for inclusion. RevMan software was used to analyze these data. Nine trials were included in this meta-analysis, which covered a total of 3141 patients. The meta-analysis showed that capecitabine group had statistically significant better pCR rates (OR, 1.34; 95% CI, 1.10–1.64; P=0.003), T downstaging rates (OR, 1.58; 95% CI, 1.22–2.06; P=0.0007), N downstaging rates (OR, 2.06; 95% CI, 1.34–3.16; P=0.001), less distant metastasis (OR, 0.63; 95% CI, 0.44–0.88; P=0.007), and lowered leucocytes (OR, 0.25; 95% CI, 0.11–0.54; P=0.0005), but with higher incidence of hand-foot syndrome (HFS) (OR, 4.43; 95% CI, 1.59–12.33; P=0.004). Capecitabine was more efficient than 5-FU in terms of tumor response in neoadjuvant treatment for patients with LARC and favourably low toxicity with the exception of HFS. [ABSTRACT FROM AUTHOR]

Purpose: To determine diagnostic performance of simple measurements on diffusion-weighted MR imaging (DWI) for assessment of complete tumour response (CR) after neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC) by signal intensity (SI) and apparent diffusion coefficient (ADC) measurements. Materials and methods: Sixty-five patients with LARC who underwent neoadjuvant CRT and subsequent surgery were included. Patients underwent pre-CRT and post-CRT 3.0 T MRI. Regions of interest of the highest brightness SI were included in the tumour volume on post-CRT DWI to calculate the SI, rSI, ADC and rADC; diagnostic performance was compared by using the receiver operating characteristic (ROC) curves. In order to validate the accuracy and reproducibility of the current strategy, the same procedure was reproduced in 80 patients with LARC at 1.5 T MRI. Results: Areas under the ROC curve for identification of a CR, based on SI, rSI, ADC, and rADC, respectively, were 0.86, 0.94, 0.66, and 0.71 at 3.0 T MRI, and 0.92, 0.91, 0.64, and 0.61 at 1.5 T MRI. Conclusion: Post-CRT DWI SI and rSI provided high diagnostic performance in assessing CR and were significantly more accurate than ADC, and rADC at 3.0 T MRI and 1.5 T MRI. Key Points: • Signal intensity ( SI) and rSI are accurate for assessment of complete response. • rSI seems to be superior to SI at 3.0 T MRI. • ADC or rADC measurements are not accurate for assessment of complete response. [ABSTRACT FROM AUTHOR]