Yuan MX, Cai QG, Zhang ZY, Zhou JZ, Lan CY, Lin JB. Application of neoadjuvant chemoradiotherapy and neoadjuvant chemotherapy in curative surgery for esophageal cancer: A meta-analysis. World J Gastrointest Oncol 2024; 16(1): 214-233 [PMID: 38292844 DOI: 10.4251/wjgo.v16.i1.214]
Corresponding Author of This Article
Jiang-Bo Lin, MD, Chief Physician, Department of Thoracic Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350000, Fujian Province, China. 18779654883@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mao-Xiu Yuan, The Graduate School, Fujian Medical University, Fuzhou 350000, Fujian Province, China
Mao-Xiu Yuan, Qi-Gui Cai, Jian-Zhong Zhou, Cai-Yun Lan, Department of Thoracic Surgery, Affiliated Hospital of Jinggangshan University, Ji’an 343000, Jiangxi Province, China
Zhen-Yang Zhang, Jiang-Bo Lin, Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350000, Fujian Province, China
Author contributions: Lin JB, Cai QG and Zhang ZY were responsible for research design; Zhou JZ, and Lan CY were responsible for conducting the experiments; Yuan MX, Cai QG, Zhang ZY and Lan CY were responsible for data acquisition; Yuan MX and Lin JB were responsible for data analysis; Yuan MX were responsible for writing the manuscript; All the authors have contributed to the completion of this paper.
Conflict-of-interest statement: No conflicts of interest exits in the submission of this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiang-Bo Lin, MD, Chief Physician, Department of Thoracic Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350000, Fujian Province, China. 18779654883@163.com
Received: September 19, 2023 Peer-review started: September 19, 2023 First decision: October 9, 2023 Revised: October 20, 2023 Accepted: December 4, 2023 Article in press: December 4, 2023 Published online: January 15, 2024
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.
Core Tip: Neoadjuvant chemoradiotherapy (nCRT) significantly improves the overall survival rate, pathological complete response rate, and R0 clearance rate for esophageal cancer. However, neoadjuvant chemotherapy (nCT) offers advantages in reducing postoperative cardiopulmonary complications and perioperative mortality. Esophageal squamous cell carcinoma patients benefit more from nCRT in terms of survival rates. The choice between nCRT and nCT should consider the patient's individual conditions and sensitivity to radiotherapy and chemotherapy. Careful consideration is necessary to achieve optimal long-term survival outcomes while minimizing complications.