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新辅助放化疗和新辅助化疗在食管癌根治性手术中的应用：一项荟萃分析。

Application of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in curative surgery for esophageal cancer: A meta-analysis.

作者信息

Yuan Mao-Xiu, Cai Qi-Gui, Zhang Zhen-Yang, Zhou Jian-Zhong, Lan Cai-Yun, Lin Jiang-Bo

机构信息

The Graduate School, Fujian Medical University, Fuzhou 350000, Fujian Province, China.

Department of Thoracic Surgery, Affiliated Hospital of Jinggangshan University, Ji'an 343000, Jiangxi Province, China.

出版信息

World J Gastrointest Oncol. 2024 Jan 15;16(1):214-233. doi: 10.4251/wjgo.v16.i1.214.

DOI:10.4251/wjgo.v16.i1.214
PMID:38292844
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10824113/
Abstract

BACKGROUND

The effectiveness of neoadjuvant therapy in esophageal cancer (EC) treatment is still a subject of debate.

AIM

To compare the clinical efficacy and toxic side effects between neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemotherapy (nCT) for locally advanced EC (LAEC).

METHODS

A comprehensive search was conducted using multiple databases, including PubMed, EMBASE, MEDLINE, Science Direct, The Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Journal Database, and Chinese Biomedical Literature Database Article. Studies up to December 2022 comparing nCRT and nCT in patients with EC were selected.

RESULTS

The analysis revealed significant differences between nCRT and nCT in terms of disease-free survival. The results indicated that nCRT provided better outcomes in terms of the 3-year overall survival rate (OSR) [odds ratio (OR) = 0.95], complete response rate (OR = 3.15), and R0 clearance rate (CR) (OR = 2.25). However, nCT demonstrated a better 5-year OSR (OR = 1.02) than nCRT. Moreover, when compared to nCRT, nCT showed reduced risks of cardiac complications (OR = 1.15) and pulmonary complications (OR = 1.30).

CONCLUSION

Overall, both nCRT and nCT were effective in terms of survival outcomes for LAEC. However, nCT exhibited better performance in terms of postoperative complications.

摘要

背景

新辅助治疗在食管癌（EC）治疗中的有效性仍是一个有争议的话题。

目的

比较新辅助放化疗（nCRT）和新辅助化疗（nCT）治疗局部晚期食管癌（LAEC）的临床疗效和毒副作用。

方法

使用多个数据库进行全面检索，包括PubMed、EMBASE、MEDLINE、Science Direct、Cochrane图书馆、中国知网、万方数据库、中国科技期刊数据库和中国生物医学文献数据库文章。选择截至2022年12月比较EC患者nCRT和nCT的研究。

结果

分析显示nCRT和nCT在无病生存方面存在显著差异。结果表明，nCRT在3年总生存率（OSR）[优势比（OR）=0.95]、完全缓解率（OR = 3.15）和R0清除率（CR）（OR = 2.25）方面提供了更好的结果。然而，nCT的5年OSR（OR = 1.02）优于nCRT。此外，与nCRT相比，nCT显示心脏并发症（OR = 1.15）和肺部并发症（OR = 1.30）的风险降低。

结论

总体而言，nCRT和nCT在LAEC的生存结果方面均有效。然而，nCT在术后并发症方面表现更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9137/10824113/3793543e9ca8/WJGO-16-214-g014.jpg
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