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<em>Meta分析</em>

doi:10.3760/cma.j.issn.1004-4221.2020.01.005

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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. Conclusion s 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.

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	Articles by authors
	Xie Ruilin
	Li Na
	Qin Qingwei
	Wang Sheng
	Zhao Xue
	Qin Zhaohui
	Yao Yuanhu

Key words： Esophageal neoplasm/neoadjuvant chemoradiotherapy Esophageal neoplasm/surgery Prognosis Meta-analysis

Received: 10 April 2019

Corresponding Authors: Yao Yuanhu,Email:yyhxz@xzhmu.edu.cn

Cite this article:

Xie Ruilin,Li Na,Qin Qingwei et al. 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[J]. Chinese Journal of Radiation Oncology, 2020, 29(1): 22-25.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2020.01.005 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2020/V29/I1/22

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