Role of Postoperative Concurrent Chemoradiotherapy for Esophageal Carcinoma: A meta-analysis of 2165 Patients.
Role of Postoperative Concurrent Chemoradiotherapy for Esophageal Carcinoma: A meta-analysis of 2165 Patients.
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食管癌术后同步放化疗的作用：2165 名患者的荟萃分析
DOI：
10.7150/jca.20940
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发表时间：
2018
影响因子：
3.9
通讯作者：
Hui Z
中科院分区：
文献类型：
--
作者：
Kang J;Chang JY;Sun X;Men Y;Zeng H;Hui Z
目的：本Meta分析旨在评价食道癌术后同期放化疗(后CCRT)的作用。方法：系统检索PubMed、PMC、EMBASE、Cochrane临床对照试验注册中心、中国国家知识基础设施和万方数据库。比较CCRT和非CCRT治疗食道癌术后患者的研究符合条件。感兴趣的结果是总生存期(OS)、局部区域复发率、远处转移率和不良事件发生率的优势比(OR)。结果：这项荟萃分析纳入了13项研究，2165名患者。CCRT后食道癌患者的OS显著改善。CCRT组与非CCRT组比较，1年、3年和5年OS的OR和95%可信区间分别为1.66[1.30~2.11]、1.50[1.24~1.81]和1.54[1.22~1.94]。放疗组局部复发率明显低于非放疗组(OR=0.58，95%CI=0.46~0.72)，远处转移率与非放疗组比较差异无统计学意义(OR=0.94，95%CI=0.68~1.30)。CCRT术后未增加肺炎、吻合口狭窄或严重血液学毒性的风险。CCRT组轻度食管炎加重，但耐受性良好。结论：这项基于最大规模已发表文献的荟萃分析证实，对于食道癌患者，后CCRT可产生显著的生存益处，并改善局部区域控制，且毒性可耐受。
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.
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影响因子：
51.1
作者：
Gebski, Val;Burmeister, Bryan;Simes, John
通讯作者：
Simes, John
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
1.7
作者：
Slim, K;Nini, E;Chipponi, J
通讯作者：
Chipponi, J
影响因子：
254.7
作者：
Torre, Lindsey A.;Bray, Freddie;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin
DOI：
10.1016/s0022-5223(03)01025-0
发表时间：
2003-11-01
影响因子：
6
作者：
Rice, TW;Adelstein, DJ;Blackstone, EH
通讯作者：
Blackstone, EH