Original communicationNeoadjuvant chemoradiotherapy for esophageal carcinoma: A meta-analysis
Section snippets
Data sources
Data sources included studies that contained original data examining the effect of neoadjuvant therapy on overall survival in esophageal cancer. The MEDLINE database was searched from January 1966 through January 2003, using the terms “esophageal neoplasm,” “carcinoma,” “adjuvant,” “chemotherapy,” “radiotherapy,” and “combined modality therapy” (Fig 1). Further articles were identified from the reference sections of relevant studies, letters, editorials, comments, and books. This strategy was
Study characteristics
We identified 6 studies that met our inclusion criteria (Table I).15, 16, 17, 18, 19, 20 Across these studies, a total of 374 patients were treated with NCRT followed by surgery and 364 patients were treated with surgery alone. Only 2 of the 6 studies19, 20 included patients with adenocarcinoma; most focused on squamous cell carcinoma. Although nearly all patients in the surgery-alone arm completed surgery, only 72% to 97% of patients in the NCRT followed by the surgery arm were able to
Discussion
We performed a meta-analysis of 6 randomized controlled trials comparing NCRT followed by surgery versus surgery alone for treating esophageal cancer. In 5 of the 6 studies in our meta-analysis there was a small, non–statistically significant trend toward improved survival with NCRT. The remaining study showed a small, statistically significant benefit of NCRT. Our summary measure, incorporating data from 6 studies and more than 700 patients, revealed a small, non–statistically significant
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