进展期食管鳞癌新辅助放化疗与新辅助化疗的<i>Meta分析</i>

doi:10.3760/cma.j.cn113030-20191112-00470

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

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.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Cheng Liang
	Gao Wei
	Tian Dong
	Yang Hao
	Ran Xingqiang
	Shi Guidong
	Gui Yan
	Fu Maoyong

Key words： Esophageal neoplasm/neoadjuvant chemoradiotherapy Esophageal neoplasm/neoadjuvant chemotherapy Meta-analysis

Received: 12 November 2019

Corresponding Authors: Fu Maoyong, Email:fumaoyongmd@163.com

Cite this article:

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.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20191112-00470 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I1/34

[1] 左婷婷,郑荣寿,曾红梅,等. 中国食管癌发病状况与趋势分析[J]. 中华肿瘤杂志, 2016, 38(9):703-708. DOI:10.3760/cma.j.issn.0253-3766.2016.09.013.
Zuo TT, Zheng RS, Zeng HM, et al. Incidence and trend analysis of esophageal cancer in China[J]. Chin J Oncol, 2016, 38(9):703-708. DOI:10.3760/cma.j.issn.0253-3766.2016.09.013.
[2] Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907)[J]. Ann Surg Oncol, 2012, 19(1):68-74. DOI:10.1245/s10434-011-2049-9.
[3] Allum WH, Stenning SP, Bancewicz J, et al. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer[J]. J Clin Oncol, 2009, 27(30):5062-5067. DOI:10.1200/jco.2009.22.2083.
[4] Van Hagen P, Hulshof MC, Van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer[J]. N Engl J Med, 2012, 366(22):2074-2084. DOI:10.1056/NEJMoa1112088.
[5] Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society:part 1[J]. Esophagus, 2019, 16(1):1-24. DOI:10.1007/s10388-018-0641-9.
[6] Watanabe M, Otake R, Kozuki R, et al. Recent progress in multidisciplinary treatment for patients with esophageal cancer[J]. Surg Today, 2019, 50(1):12-20. DOI:10.1007/s00595-019-01878-7.
[7] Sanford NN, Catalano PJ, Enzinger PC, et al. A retrospective comparison of neoadjuvant chemoradiotherapy regimens for locally advanced esophageal cancer[J]. Dis Esophagus, 2017, 30(7):1-8. DOI:10.1093/dote/dox025.
[8] 周国志,吴清泉. 术前同步放化疗在食管癌综合治疗中的作用[J]. 世界华人消化杂志, 2012, 20(17):1526-1530. DOI:10.11569/wcjd.v20.i17.1526.
Zhou GZ, Wu QQ. Role of preoperative chemoradiotherapy in the comprehensive treatment of esophageal cancer[J]. World Chin J Dig, 2012, 20(17):1526-1530. DOI:10.11569/wcjd.v20.i17.1526.
[9] Nygaard K, Hagen S, Hansen HS, et al. Pre-operative radiotherapy prolongs survival in operable esophageal carcinoma:a randomized, multicenter study of pre-operative radiotherapy and chemotherapy. The second Scandinavian trial in esophageal cancer[J]. World J Surg, 1992, 16(6):1104-1110. DOI:10.1007/BF02067069.
[10] Cao XF, He XT, Ji L, et al. Effects of neoadjuvant radiochemotherapy on pathological staging and prognosis for locally advanced esophageal squamous cell carcinoma[J]. Dis Esophagus, 2009, 22(6):477-481. DOI:10.1111/j.1442-2050.2008.00910.x.
[11] Von Dobeln GA, Klevebro F, Jacobsen AB, et al. Neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for cancer of the esophagus or gastroesophageal junction:long-term results of a randomized clinical trial[J]. Dis Esophagus, 2018, 32(2). DOI:10.1093/dote/doy078.
[12] Klevebro F, Lindblad M, Johansson J, et al. Outcome of neoadjuvant therapies for cancer of the oesophagus or gastro-oesophageal junction based on a national data registry[J]. Br J Surg, 2016, 103(13):1864-1873. DOI:10.1002/bjs.10304.
[13] 李雪,郝大选,杨原源,等. 局部进展期食管鳞癌新辅助放化疗与新辅助化疗比较[J]. 中华放射肿瘤学杂志, 2017, 26(3):274-278. DOI:10.3760/cma.j.issn.1004?4221.2017.03.006.
Li X, Hao DX, Yang YY, et al. Comparison of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in treating locally advanced esophageal squamous cell carcinoma[J]. Chin J Radiat Oncol, 2017, 26(3):274-278. DOI:10.3760/cma.j.issn.1004?4221.2017.03.006.
[14] 郑浩,汪灏,唐汉,等. 新辅助同步放化疗与新辅助化疗治疗局部进展期食管鳞癌的疗效分析[J]. 中华消化外科杂志, 2017,16(5):464-468. DOI:10.3760/cma.j.issn.1673-9752.2017.05.006.
Zheng H, Wang H, Tang H, et al. Effect analysis of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in the treatment of locally advanced esophageal squamous cell carcinoma[J]. Chin J Dig Surg, 2017, 16(5):464-468. DOI:10.3760/cma.j.issn.1673-9752.2017.05.006.
[15] Nakashima Y, Saeki H, Hu Q, et al. Neoadjuvant chemotherapy versus chemoradiotherapy for patients with esophageal squamous cell carcinoma[J]. Anticancer Res, 2018, 38(12):6809-6814. DOI:10.21873/anticanres.13053.
[16] Zheng Y, Liu X, Zhang R, et al. Neoadjuvant chemotherapy with or without neoadjuvant radiotherapy compared with neoadjuvant chemoradiotherapy for esophageal cancer[J]. J Thorac Dis, 2018, 10(8):4715-4723. DOI:10.21037/jtd.2018.07.124.
[17] Bharat A, Crabtree T. Management of advanced-stage operable esophageal cancer[J]. Surg Clin North Am, 2012, 92(5):1179-1197. DOI:10.1016/j.suc.2012.07.012.
[18] 曹秀峰,王山,吴必超,等. 新辅助放化疗对中晚期食管鳞癌病理分期及预后的影响[J]. 世界华人消化杂志, 2007, 15(22):2413-2417. DOI:10.3969/j.issn.1009-3079.2007.22.009.
Cao XF, Wang S, Wu BC, et al. Effects of neoadjuvant radiochemotherapy on pathological stage and prognosis of middle and advanced esophageal carcinoma[J]. World Chin J Dig, 2007, 15(22):2413-2417. DOI:10.3969/j.issn.1009-3079.2007.22.009.
[19] Klevebro F, Von Dobeln GA, Wang N, et al. A randomized clinical trial of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for cancer of the oesophagus or gastro-oesophageal junction[J]. Ann Oncol, 2016, 27(4):660-667. DOI:10.1093/annonc/mdw010.
[20] Hao D, Li X, Yang Y, et al. Neoadjuvant chemoradiotherapy versus chemotherapy and surgery for patients with locally advanced esophageal squamous cell carcinoma[J]. Translational Cancer Research, 2017, 6(2):346-353. DOI:10.21037/tcr.2017.03.34.
[21] Tang H, Zheng H, Tan L, et al. Neoadjuvant chemoradiotherapy followed by minimally invasive esophagectomy:is it a superior approach for locally advanced resectable esophageal squamous cell carcinoma?[J]. J Thorac Dis, 2018, 10(2):963-972. DOI:10.21037/jtd.2017.12.108.
[22] Whited WM, Trivedi JR, Bond ER, et al. Optimal therapy in locally advanced esophageal cancer:a national cancer database analysis[J]. J Gastrointest Surg, 2018, 22(2):187-193. DOI:10.1007/s11605-017-3548-1.
[23] Morgan MA, Lewis WG, Crosby TD, et al. Prospective cohort comparison of neoadjuvant chemoradiotherapy versus chemotherapy in patients with oesophageal cancer[J]. Br J Surg, 2007, 94(12):1509-1514. DOI:10.1002/bjs.5671.
[24] Donahue JM, Nichols FC, Li Z, et al. Complete pathologic response after neoadjuvant chemoradiotherapy for esophageal cancer is associated with enhanced survival[J]. Ann Thorac Surg, 2009, 87(2):392-399. DOI:10.1016/j.athoracsur.2008.11.001.
[25] Stahl M, Walz MK, Riera-knorrenschild J, et al. Preoperative chemotherapy versus chemoradiotherapy in locally advanced adenocarcinomas of the oesophagogastric junction (POET):long-term results of a controlled randomised trial[J]. Eur J Cancer, 2017, 81:183-190. DOI:10.1016/j.ejca.2017.04.027.
[26] 郭旭峰,叶波,杨煜,等. 局部进展期食管癌新辅助治疗后微创手术可行性分析的病例对照研究[J]. 中国胸心血管外科临床杂志, 2018, 25(03):203-207. DOI:10.7507/1007-4848.201708035.
Guo XF, Ye B, Yang Y, et al. Feasibility of neoadjuvant therapy followed by minimally invasive esophagectomy for locally advanced esophageal cancer:a case control study[J]. Chin J Clin Thorac Cardiovasc Surg, 2018, 25(03):203-207. DOI:10.7507/1007-4848.201708035.
[27] Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma:an updated meta-analysis[J]. Lancet Oncol, 2011, 12(7):681-692. DOI:10.1016/s1470-2045(11)70142-5.
[28] Nakamura K, Kato K, Igaki H, et al. Three-arm phase Ⅲ trial comparing cisplatin plus 5-FU (CF) versus docetaxel, cisplatin plus 5-FU (DCF) versus radiotherapy with CF (CF-RT) as preoperative therapy for locally advanced esophageal cancer (JCOG1109, NExT study)[J]. Jpn J Clin Oncol, 2013, 43(7):752-755. DOI:10.1093/jjco/hyt061.
[29] Tang H, Tan L, Shen Y, et al. CMISG1701:a multicenter prospective randomized phase Ⅲ clinical trial comparing neoadjuvant chemoradiotherapy to neoadjuvant chemotherapy followed by minimally invasive esophagectomy in patients with locally advanced resectable esophageal squamous cell carcinoma (cT3-4aN0-1M0)(NCT03001596)[J]. BMC Cancer, 2017, 17(1):450. DOI:10.1186/s12885-017-3446-7.