Li Shenglei, Liu Hongtao, Diao Changying, Wang Xiaohui, Gao Ming, Li Zongming, Song Lijie, Gao Xianzheng, Han Jing, Wang Feng, Li Wencai, Han Xinwei
Department of Pathology, The First Affliated Hospital of Zhengzhou University, Zhengzhou, Henan, 50000, China.
Laboratory for Cell Biology, College of Life Sciences of Zhengzhou University, Zhengzhou, Henan, 450001, China.
Oncotarget. 2017 May 30;8(22):36339-36353. doi: 10.18632/oncotarget.16193.
This network meta-analysis was conducted to assess whether the efficacy of surgery with adjuvant therapies, including radiotherapy (RT+S), chemotherapy (CT+S), and chemoradiotherapy (CRT+S) have better performance in esophageal cancer treatment and management. PubMed and EMBASE were used to search for relevant trials. Both conventional pair-wise and network meta-analyses were carried out. The surface under the cumulative ranking curve (SUCRA) was used to rank interventions based on the efficacy of the treatment method. As for 3-year overall survival (OS), CRT+S showed the highest efficacy (CRT+S vs.
HR=0.81, 95% CrI =0.73-0.90; CRT+S vs. CT+S: HR=0.82, 95% CrI =0.70-0.95; CRT+S vs. RT+S: HR=0.77, 95% CrI =0.62-0.95). For disease-free survival, CRT+S showed efficacy over CT+S ((HR =0.70, 95% CrI =0. 59-0.83). In conclusion, CRT+S showed a better performance for survival outcomes and ranks best among all therapies. The results of our study can provide guidance for medical decisions and treatment options that may help clinical practitioners improve the efficacy of EC treatment.
进行这项网状Meta分析是为了评估手术联合辅助治疗（包括放疗（RT+S）、化疗（CT+S）和放化疗（CRT+S））在食管癌治疗与管理中是否具有更好的效果。使用PubMed和EMBASE检索相关试验。同时进行了传统的成对Meta分析和网状Meta分析。累积排序曲线下面积（SUCRA）用于根据治疗方法的疗效对干预措施进行排序。至于3年总生存期（OS），CRT+S显示出最高的疗效（CRT+S对比手术：HR=0.81，95%可信区间=0.73-0.90；CRT+S对比CT+S：HR=0.82，95%可信区间=0.70-0.95；CRT+S对比RT+S：HR=0.77，95%可信区间=0.62-0.95）。对于无病生存期，CRT+S显示出优于CT+S的疗效（HR =0.70，95%可信区间=0.59-0.83）。总之，CRT+S在生存结局方面表现更佳，在所有治疗方法中排名最高。我们的研究结果可为医疗决策和治疗选择提供指导，这可能有助于临床医生提高食管癌治疗的疗效。
