Efficacy and safety of neoadjuvant chemotherapy versus neoadjuvant concurrent radiochemotherapy for resectable esophageal squamous cell carcinoma: a meta-analysis / 中华胸心血管外科杂志

ABSTRACT

Objective:To systematic review the clinical efficacy and safety of neoadjuvant chemotherapy and neoadjuvant concurrent chemoradiotherapy for resectable esophageal squamous cell carcinoma.Methods:Literature search was performed from Web of Science, Pubmed, Cochrane Library, Embase, CBM, Wanfang Data, CNKI and Chongqing VIP. The clinical controlled studies of neoadjuvant chemotherapy versus neoadjuvant concurrent chemoradiation in the treatment of resectable esophageal squamous cell carcinoma was searched. Relevant outcome indicators were analyzed by Revman 5.3 statistical software.Results:Nine studies were included, with a total of 1, 369 patients. Compared with the neoadjuvant chemoradiotherapy, the neoadjuvant chemotherapy had lower overall survival rates at 3 and 5 years( OR=0.68, 95% CI 0.53-0.86, P<0.05; OR=0.51, 95% CI 0.34-0.77, P<0.05) , lower pathological complete remission rate( OR=0.28, 95% CI 0.18-0.45, P<0.05)and R0 resection rate( OR=0.39, 95% CI 0.22-0.68, P<0.05), The total postoperative complication rate is similar( OR=1.07, 95% CI 0.75-1.51, P>0.05). Conclusion:Neoadjuvant concurrent radiochemotherapy maybe superior to neoadjuvant chemotherapy among patients with resectable esophageal squamous cell carcinoma.