Efficacy and safety of neoadjuvant concurrent chemoradiotherapy followed by surgery versus surgery alone in the treatment of resectable esophageal squamous cell carcinoma: a Meta-analysis
10.3760/cma.j.issn.1004-4221.2020.01.005
- VernacularTitle: 可切除食管鳞癌新辅助同步放化疗加手术对比单纯手术的疗效及安全性Meta分析
- Author:
Ruilin XIE
1
;
Na LI
2
;
Qingwei QIN
2
;
Sheng WANG
2
;
Xue ZHAO
2
;
Zhaohui QIN
3
;
Yuanhu YAO
1
Author Information
1. Department of Radiation Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
2. School of Graduate, Xuzhou Medical University, Xuzhou 221004, China
3. School of Public Health, Xuzhou Medical University, Xuzhou 221004, China
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasm/neoadjuvant chemoradiotherapy;
Esophageal neoplasm/surgery;
Prognosis;
Meta-analysis
- From:
Chinese Journal of Radiation Oncology
2020;29(1):22-25
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the efficacy and safety between neoadjuvant concurrent chemoradiotherapy followed by surgery and surgery alone in the treatment of resectable esophageal squamous cell carcinoma.
Methods:Literature review was performed from Embase, PubMed, Web of Science, Cochrane Library, CBM, Wanfang Data, CNKI and Chongqing VIP. The randomized controlled clinical trials of concurrent chemoradiotherapy followed by surgery versus surgery alone in the treatment of resectable esophageal squamous cell carcinoma were retrieved. The meta-analysis of survival data, R0 resection rate, incidences of postoperative complications and peritreatment mortality was conducted by using RevMan 5.3 software.
Results:A total of 1450 patients from 11 controlled clinical trials were included in this meta-analysis. The results of the meta-analysis showed that concurrent chemoradiotherapy followed by surgery group had significantly higher 2-and 5-year overall survival rate (RR=1.14, 95%CI: 1.05-1.23, P=0.00) and progression-free survival rate (RR=1.56, 95%CI: 1.05-2.32, P=0.03). R0 resection rate were also improved in concurrent chemoradiotherapy followed by surgery group (RR=1.10, 95%CI: 1.05-1.14, P=0.00). Compared with the surgery alone group, the incidence of arrhythmia in the concurrent chemoradiotherapy plus surgery group was significantly higher (RR=2.45, 95%CI: 1.37-4.38, P=0.00). However, there was no significant difference in the overall incidence of postoperative complications (RR=1.12, 95%CI: 0.79-1.59, P=0.51) and incidence of peritreatment mortality (RR=1.78, 95%CI: 0.90-3.52, P=0.10) between two groups.
Conclusions:Neoadjuvant concurrent chemoradiotherapy followed by surgery improves the survival and R0 resection rate over surgery alone among patients with resectable esophageal squamous cell carcinoma, whereas it does not increase the risk of postoperative complications. Consequently, neoadjuvant concurrent chemoradiotherapy followed by surgery is an optimal treatment for patients with resectable esophageal squamous cell carcinoma.
