Neoadjuvant chemoradiotherapy for resectable esophageal carcinoma: A meta-analysis

Table 1 Features of all trials included in the meta-analysis

Country	Year of RCT published	SCC or AC	Schedule of radiotherapy	Schedule of chemotherapy	Concurrent or sequential	Time of surgery
Norway	1992	SCC	35 Gy	Cisplatin: 20 mg/m2 D1-5, D15-19	Sequential	Not report
			1.75 Gy/d	Bleomycin: 10 mg/m2 D1-5, D15-19
			5 d/wk for 4 wk
Thailand	1994	SCC	40 Gy	Cisplatin: 100 mg/m2 D1, 29	Concurrent	4 wk after completion of chemotherapy
			2 Gy/d	FU: 1000 mg/m2 D1, D29-32
			5 d/wk for 4 wk
France	1994	SCC	20 Gy	Cisplatin: 100 mg/m2 D1,21	Sequential	D42
			2 Gy/d	FU: 600 mg/m2 D2-5, D22-25
			D8-19
Ireland	1996	AC	40 Gy	Cisplatin: 75 mg/m2 D7	Concurrent	8 wk after CRT
			2.67 Gy/ d	FU: 15 mg/kg D1-5
			D1-5, 8-12, 15-19	Week 1 and week 6
France	1997	SCC	37 Gy	Cisplatin: 80 mg/m2 D0-2	Sequential	2-4 wk after CRT
			3.7 Gy/d
			5 d/wk for 2 wk
USA	2001	SCC and AC	45 Gy	Cisplatin: 20 mg/m2 D1-5, 17-21	Concurrent	D42
			1.5 Gy bid	FU: 300 mg/m2 D1-21
			D1-5, 8-12, 15-19	Vinblastine: 1 mg/m2 D1-4, 17-20
China	2003	SCC	36 Gy	Cisplatin: 25 mg/m2 D2-5, D22-25	Sequential	3 wk after CRT
			3 Gy/d	FU: 1000 mg/m2 D1-5
			D21-24, 28-31, 35-38	500 mg/m2 D21-25
Korea	2004	SCC	45.6 Gy	Cisplatin: 60 mg/m2 D1, 21	Concurrent	3-4 wk after completion of radiotherapy
			1.2 Gy bid	FU: 1000 mg/m2 D2-5
			D1-28
Australia	2005	SCC and AC	35 Gy	Cisplatin: 80 mg/m2 D1	Concurrent	3-6 wk after completion of radiotherapy
			2.33 Gy/d	FU: 800 mg/m2 D2-5
			5 d/wk for 3 wk
Japan	2006	SCC	40 Gy	Cisplatin: 7 mg/m2	Concurrent	35-40 d after CRT
			2 Gy/d	FU: 350 mg/m2
			5 d/wk for 4 wk	5 d/wk for 4-6 wk
USA	2008	SCC and AC	50.4 Gy	Cisplatin: 100 mg/m2 D1,29	Concurrent	3-8 wk after CRT
			1.8 Gy/d	FU: 1000 mg/m2 D1-4, D29-32
			5 d/wk for 5.5 wk

SCC: Squamous cell carcinoma; AC: Adenocarcinoma; CRT: Chemoradiotherapy.

Table 2 Survival rate estimates of patients with EC by schedule of chemoradiotherapy

Schedule of CRT	Overall survival	No. of studies	No. of patients		OR (95% CI)	P
			CRT + S	S
Sequential	1 yr	3	237	234	1.12 (0.77, 1.64)	0.56
	3 yr	3	237	234	1.24 (0.82, 1.88)	0.31
	5 yr	2	191	188	1.24 (0.81, 1.91)	0.32
Concurrent	1 yr	6	352	343	1.41 (1.03, 1.94)	0.03
	3 yr	7	374	366	2.12 (1.20, 3.76)	0.011
	5 yr	5	265	261	1.72 (1.10, 2.71)	0.02

¹Random effects model was used. EC: Esophageal carcinoma; CRT + S: Neoadjuvant chemoradiotherapy and surgery; S: Surgery; OR: Odds ratio; CI: Confidence interval.

Table 3 Survival rate estimates of patients with ESCC for neoadjuvant chemoradiotherapy compared with surgery alone

Overall survival	No. of studies	No. of patients		OR (95% CI)	P
		CRT + S	S
1 yr	6	368	368	1.16 (0.85, 1.57)	0.34
3 yr	7	390	391	1.34 (0.98, 1.82)	0.07
5 yr	5	293	295	1.41 (0.98, 2.02)	0.06

ESCC: Esophageal squamous cell carcinoma.

Table 4 Three-year survival in different population

Population	No. of studies	No. of patients		OR (95% CI)	P
		CRT + S	S
USA	2	80	76	3.74 (1.77, 7.88)	0.0005
Europe	4	295	289	1.59 (1.09, 2.33)	0.02
Asia	3	108	107	1.27 (0.72, 2.24)	0.40