Survival and complications after neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for esophageal squamous cell cancer: A meta-analysis

Yaru Guo; Mingna Xu; Yufei Lou; Yan Yuan; Yuling Wu; Longzhen Zhang; Yong Xin; Fengjuan Zhou

doi:10.1371/journal.pone.0271242

Survival and complications after neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for esophageal squamous cell cancer: A meta-analysis

PLoS One. 2022 Aug 5;17(8):e0271242. doi: 10.1371/journal.pone.0271242. eCollection 2022.

Authors

Yaru Guo^{1

2}, Mingna Xu^{1

2}, Yufei Lou^{1

2}, Yan Yuan^{1

2}, Yuling Wu^{1

2}, Longzhen Zhang¹, Yong Xin^{1

2}, Fengjuan Zhou^{2

3}

Affiliations

¹ Department of Radiation, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
² First Clinical College, Xuzhou Medical University, Xuzhou, China.
³ Department of Radiation, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

Abstract

Objectives: To compare the survival and complications of neoadjuvant chemoradiation (NCRT) versus neoadjuvant chemotherapy (NCT) for esophageal squamous cell carcinoma (ESCC).

Methods: We conducted a systematic literature search of the PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, Wanfang Data, CBM, and VIP databases from inception to November 2021. Meta-analyses were performed using RevMan (version 5.3) and Stata version 15.0.

Results: A total of 18 studies were included, which involved 3137 patients, The results of the metaanalysis showed that the pathological complete remission rate (odds ratio [OR] = 5.21, 95% confidence interval [CI]: 2.85-9.50, p<0.00001) and complete tumor resection rate (OR = 2.31, 95% CI: 1.57-3.41, p<0.0001) in the NCRT group were significantly better than those in the NCT group. Our meta-analysis results showed that 1-, 3-, and 5-year survival rates (1-year overall survival [OS]: OR = 1.51, 95% CI: 1.11-2.05, p = 0.009; 3-year OS: OR = 1.73, 95% CI: 1.36-2.21, p<0.0001; 5-year OS: OR = 1.61, 95% CI: 1.30-1.99, p<0.00001) in the NCRT group were significantly higher than those in the NCT group. NCRT can lead a significant survival benefit compared with NCT and there was no significant difference between the two neoadjuvant treatments in terms of postoperative complications.

Conclusion: The use of NCRT in the treatment of patients with ESCC patients showed significant advantages in terms of survival and safety relative to the use of NCT.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Squamous Cell* / drug therapy
Chemoradiotherapy / adverse effects
Chemoradiotherapy / methods
Epithelial Cells
Esophageal Neoplasms*
Esophageal Squamous Cell Carcinoma* / drug therapy
Esophagectomy / adverse effects
Humans
Neoadjuvant Therapy / adverse effects
Neoadjuvant Therapy / methods

Grants and funding

This research is funded by Innovative Research Group Project of the National Natural Science Foundation of China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.