Meta-analysis of clinical value of adjuvant radiotherapy versus surgery alone in the treatment of stage pT 2-3N 0M 0 esophageal squamous cell carcinoma
10.3760/cma.j.cn113030-20230317-00052
- VernacularTitle:辅助放疗与单纯手术治疗pT 2-3N 0M 0期食管鳞癌临床价值的meta分析
- Author:
Li CUI
1
;
Wanxi QU
;
Shiwang YUAN
;
Minhan WANG
;
Jiang WANG
;
Zhaohui QIN
;
Yuanhu YAO
Author Information
1. 徐州医科大学附属医院肿瘤放射治疗科，徐州 221006
- Keywords:
Esophageal squamous cell carcinoma;
Radiotherapy, adjuvant;
Radical surgery;
Prognosis;
Meta-analysis
- From:
Chinese Journal of Radiation Oncology
2024;33(2):116-122
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and safety of adjuvant radiotherapy versus surgery alone in patients with stage pT 2-3N 0M 0 esophageal squamous cell carcinoma after radical resection. Methods:The search was conducted through Web of Science, Emabse, PubMed, Cochrane Library, CNKI, Chongqing VIP, China Biomedical Literature Database, and Wanfang database, etc. The search time was ranged from the establishment of the database to December 2022. Searched studies were screened according to the inclusion and exclusion criteria. Review Manager 5.4 software was used for analysis.Results:Clinical data of 2 424 patients from 8 controlled clinical studies were finally included. Meta-analysis showed that postoperative adjuvant radiotherapy had higher 3-year and 5-year disease-free survival rates ( OR=2.33, 95%CI=1.71-3.17, P<0.001; OR=2.38, 95% CI=1.73-3.27, P<0.001) and 3-year and 5-year overall survival rates ( OR=1.89, 95% CI=1.37-2.60, P<0.01; OR=1.94,95% CI=1.50-2.49, P<0.001) than surgery alone. Meanwhile, the local recurrence rate ( OR=0.33, 95% CI=0.21-0.50, P<0.001) and distant metastasis rate ( OR=0.62, 95% CI=0.39-0.98, P=0.040) of postoperative adjuvant radiotherapy group were lower than those in the surgery alone group. The incidence of radiation esophagitis (1.4%-9.5%), radiation pneumonitis (2.1%) and anastomotic stenosis (5.3%) was reported. Conclusions:For patients with stage pT 2-3N 0M 0 squamous cell carcinoma after radical resection of esophageal cancer, adjuvant radiotherapy may improve 3-year and 5-year disease-free survival rates and 3-year and 5-year overall survival rates compared with surgery alone. In addition, adjuvant radiotherapy may reduce the local recurrence and distant metastasis rates. Therefore, postoperative adjuvant radiotherapy is an optional treatment for stage pT 2-3N 0M 0 esophageal squamous cell carcinoma.
