Meta-analysis of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy for advanced esophageal squamous cell carcinoma
Cheng Liang1, Gao Wei1, Tian Dong1, Yang Hao1, Ran Xingqiang1, Shi Guidong1, Gui Yan2, Fu Maoyong1
1Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China; 2Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
Abstract：Objective To systematically evaluate the efficacy and safety of neoadjuvant chemoradiotherapy (NCRT) plus surgery versus neoadjuvant chemotherapy (NCT) plus surgery in the treatment of advanced esophageal squamous cell carcinoma. Methods Clinical controlled trials of comparing the treatment of NCRT plus surgery with NCT plus surgery for esophageal squamous cell carcinoma were electronically searched from the databases including PubMed, The Cochrane Library, EMbase, CBM, CNKI, WanFang and VIP from the inception of databases to January, 2019. Two reviewers independently screened the literatures, extracted data and assessed the risk of bias of the included studies. And then, a meta-analysis was performed by using RevMan 5.3 software. Results A total of 8 clinical control studies were included, including 995 patients with esophageal squamous cell carcinoma. Meta-analysis Results showed that compared with the NCT group, the R0 resection rate was significantly higher(OR=2.14, 95%CI:1.03-4.45, P=0.040)and the pathological complete response (pCR) rate was significantly higher(OR=4.19, 95%CI:1.71-10.28, P=0.002)in the NCRT group. The incidence of postoperative complications (OR=1.37, 95%CI:0.76-2.48, P=0.300) and the risk of perioperative death (OR=1.28, 95%CI:0.58-2.83, P=0.54) were not significantly different between two groups. The long-term survival of patients with esophageal squamous cell carcinoma in the NCRT group was significantly better compared with that in the NCT group (HR=0.77, 95%CI:0.64-0.92, P=0.005). Conclusions Compared with NCT plus surgery for advanced esophageal squamous cell carcinoma, NCRT plus surgery has higher R0 resection rate and pCR rate,does not significantly increase the risk of perioperative complications or perioperative death, and significantly improves the long-term survival of esophageal squamous cell carcinoma patients.
Cheng Liang,Gao Wei,Tian Dong et al. Meta-analysis of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy for advanced esophageal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2021, 30(1): 34-41.
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