Role of Postoperative Concurrent Chemoradiotherapy for Esophageal Carcinoma: A meta-analysis of 2165 Patients

被引:31
作者
Kang, Jingjing [1 ,2 ]
Chang, Joe Y. [3 ]
Sun, Xin [1 ,2 ]
Men, Yu [1 ,2 ]
Zeng, Hongmei [2 ,4 ]
Hui, Zhouguang [1 ,2 ,5 ]
机构
[1] Chinese Acad Med Sci, Canc Hosp, Natl Canc Ctr, Dept Radiat Oncol, 17 Panjiayuan Nanli, Beijing 100021, Peoples R China
[2] Peking Union Med Coll, 17 Panjiayuan Nanli, Beijing 100021, Peoples R China
[3] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA
[4] Chinese Acad Med Sci, Canc Hosp, Natl Canc Ctr, Natl Off Canc Prevent & Control, Beijing, Peoples R China
[5] Chinese Acad Med Sci, Canc Hosp, Natl Canc Ctr, Dept VIP Med Serv, 17 Panjiayuan Nanli, Beijing 100021, Peoples R China
基金
中国国家自然科学基金;
关键词
esophageal carcinoma; postoperative concurrent chemoradiotherapy; survival; recurrence; toxicity; meta-analysis; SQUAMOUS-CELL CARCINOMA; RESECTABLE ESOPHAGEAL; RADIATION-THERAPY; NEOADJUVANT CHEMORADIOTHERAPY; ADJUVANT CHEMORADIOTHERAPY; THORACIC ESOPHAGUS; RECURRENCE PATTERN; SURVIVAL BENEFITS; CHEMOTHERAPY; SURGERY;
D O I
10.7150/jca.20940
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: This meta-analysis was aimed to evaluate the role of postoperative concurrent chemoradiotherapy (post-CCRT) for esophageal cancer patients after surgery. Methods: We systematically searched PubMed, PMC, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure and Wanfang databases. Studies which compared CCRT with non-CCRT treatment for esophageal cancer patients after surgery were eligible. Outcomes of interest were odds ratios (OR) for overall survival (OS), local-regional recurrence rate, distant metastasis rate and adverse-event rate. Results: Thirteen studies with 2165 patients were included in this meta-analysis. Post-CCRT significantly improved OS for esophageal cancer patients. Comparing the CCRT group with the non-CCRT one, the OR and 95% confidence interval (CI) for 1-year, 3-year and 5-year OS were 1.66 [1.30-2.11], 1.50 [1.24-1.81] and 1.54 [1.22-1.94], respectively. The local-regional recurrence rate was significantly reduced in the CCRT group (OR=0.58, 95% CI=0.46-0.72), but no significant difference was observed in the distant metastasis rate between the CCRT and non-CCRT groups (OR=0.94, 95% CI=0.68-1.30). Post-CCRT didn't increase the risk of pneumonitis, anastomotic stenosis or severe hematologic toxicities. Mild esophagitis in the CCRT group was increased but could be well tolerated. Conclusions: This meta-analysis based on the largest-scale of published literature confirms that post-CCRT yields significant survival benefit and improves local-regional control with tolerable toxicity for patients with esophageal carcinoma.
引用
收藏
页码:584 / 593
页数:10
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