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Review
. 2017 Mar 21;8(12):20410-20417.
doi: 10.18632/oncotarget.14669.

Concurrent neoadjuvant chemoradiotherapy could improve survival outcomes for patients with esophageal cancer: a meta-analysis based on random clinical trials

Baoxing Liu  1 , Yacong Bo  2 , Kunlun Wang  1 , Yang Liu  1 , Xiance Tang  1 , Yan Zhao  1 , Erjiang Zhao  1 , Ling Yuan  1
Affiliations
Review

Concurrent neoadjuvant chemoradiotherapy could improve survival outcomes for patients with esophageal cancer: a meta-analysis based on random clinical trials

Baoxing Liu et al. Oncotarget. .

Abstract

Background: The long-term survival benefit of concurrent neoadjuvant chemoradiotherapy in patients with resectable esophageal cancer remains controversial. In the present study, we conducted a meta-analysis to assess these effectiveness.

Methods: We searched for most relevant studies published up to the end of August 2016, using Pubmed and web of knowledge. And additional articles were identified from previous meta-analysis. The hazard ratio (HR, for overall survival and progression free survival) or risk ratio (RR, for R0 resection) with its corresponding 95 % confidence interval (CI) were used to assess the pooled effect.

Results: Twelve articles including 1756 patients were included in the meta-analysis. Concurrent neoadjuvant chemoradiotherapy followed by surgery was associated with significantly improved overall survival (HR=0.76 , 95% CI= 0.68-0.86), progression survival (HR =0.69, 95% CI= 0.59-0.81), and R0 resection rate(RR =1.17, 95% CI= 1.03-1.33). Subgroup analysis suggested that concurrent neoadjuvant chemoradiotherapy could improve overall survival outcome for squamous cell carcinoma (HR=0.73, 95%CI=0.61-0.88) but not those for adenocarcinoma (HR=0.72, 95%CI=0.48-1.04).

Conclusion: Our findings suggested that concurrent neoadjuvant chemoradiotherapy was associated with a significant survival benefit in patients with esophageal cancer.

Keywords: R0 resection rate; esophageal cancer; neoadjuvant concurrent chemoradiotherapy; overall survival; progression-free survival.

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Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflicts of interest were disclosed.

Figures

Figure 1
Figure 1. The flow diagram of screened, excluded, and analyzed publications
Figure 2
Figure 2. Meta analysis comparing the overall survival between neoadjuvant chemoradiotherapy plus surgery and surgery alone. CI, confidence interval; HR, hazard ratio
Figure 3
Figure 3
Meta analysis comparing the secondary outcomes of patients receiving neoadjuvant chemoradiotherapy plus surgery and surgery alone (A: R0 resection; B: progression-free survival).
Figure 4
Figure 4. Funnel plot for publication bias of overall survival between neoadjuvant chemoradiotherapy plus surgery and surgery alone
See this image and copyright information in PMC

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