ObjectiveTo systematically review the efficacy and safety of chemo-radiotherapy combined with hyperthermia (HCRT) for rectal cancer, and to provide evidence for clinical practice. MethodsWe searched the Cochrane Library (Issue 6, 2014), PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data databases from inception to July 2014. All relevant randomized controlled trials (RCTs) of HCRT for rectal cancer were collected. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 9 RCTs involving 663 patients were included. The results of meta-analysis showed that:Compared with the chemo-radiotherapy (CRT) group, the HCRT group were significant superior in complete response (OR=3.74, 95%CI 2.14 to 6.53), total effective rate (OR=4.23, 95%CI 2.69 to 6.66), 3-year survival rate (OR=4.48, 95%CI 1.81 to 11.06) and recurrence rate (OR=0.19, 95%CI 0.09 to 0.42). ②Compared with the radiotherapy (RT) group, the HCRT group was associated with significant improvement in complete response rate (OR=3.01, 95%CI 1.24 to 7.29). ConclusionCurrent evidence shows, HCRT is superior to CRT or RT in the treatment of rectal cancer. However, due to the limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.