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Concurrent chemoradiotherapy for esophageal squamous cell carcinoma:a meta-analysis
WANG Jun*, YU Jin-ming, JING Shao-wu, CHENG Yun-jie, LIU Qing, WANG Yi, CAO Feng, YANG Cong-rong.*
Tianjin Medical University, Tianjin 300070, China;Department of Radiation Oncology, Fourth Hospital of HeBei Medical University,Shijiazhuang 050011, China
Abstract Objective To analyze the efficacy and toxicities of concurrent chemoradiotherapy (CCRT) in the non-surgical treatment of esophageal squamous cell carcinoma (ESCC) in China and to provide evidence for its clinical application. Methods CNKI and Wanfang Data were searched to identify the randomized controlledor case-controlled trials of CCRT for ESCC. A meta-analysis was performed to evaluate the efficacy and safety of CCRT for ESCC in China. Results A total of 39 randomized controlledor case controlledtrials involving 4161 patients were included in the meta-analysis. The meta-analysis showed that compared with those receiving radiotherapy alone, the ESCC patients receiving CCRT had significantly improved short-term outcomes (OR=2.588, P=0.000) and significantly increased 1-, 3-, and 5-year survival rates (HR=1.995, P=0.000;HR=2.047, P=0.000;HR=2.265, P=0.000), but they also had significantly increased incidence rates of radiation esophagitis (grade ≥3), radiation pneumonia (grade ≥2), and bone marrow suppression (grade ≥3)(OR=4.372, P=0.000;OR=1.962, P=0.005;OR=4.403, P=0.000). Among the ESCC patients receiving CCRT, those treated with paclitaxel-containing regimen had significantly improved short-term outcomes (OR=1.868, P=0.036) and similar 1-and 3-year survival rates (HR=1.087, P=0.781;HR=1.315, P=0.569), as compared with those treated with FP regimen. Conclusions CCRT can significantly improve the short-term outcome and long-term survival in ESCC patients, but it also increases the incidence of toxicities. Paclitaxel-containing regimen has better short-term efficacy than standard FP regimen among ESCC patients receiving CCRT.
WANG Jun,YU Jin-ming,JING Shao-wu et al. Concurrent chemoradiotherapy for esophageal squamous cell carcinoma:a meta-analysis[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 446-449.
WANG Jun,YU Jin-ming,JING Shao-wu et al. Concurrent chemoradiotherapy for esophageal squamous cell carcinoma:a meta-analysis[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 446-449.