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Effects of neoadjuvant chemotherapy vs chemoradiotherapy in the treatment of esophageal adenocarcinoma:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第11期30卷 1621-1635页

作者： Armand Csontos Alíz Fazekas Lajos szakó Nelli Farkas Csenge Papp Szilárd Ferenczi sza.olcs bellyei Péter Hegyi András Papp Department of Surgery University of PécsMedical SchoolClinical CenterPécs H-7624BaranyaHungary Institute of Bioanalysis University of PécsMedical SchoolPécs H-7624BaranyaHungary Institute for Translational Medicine University of PécsMedical SchoolPécs H-7624BaranyaHungary Department of Emergency Medicine Clinical CenterUniversity of PécsMedical SchoolPécs 7624BaranyaHungary Department of Oncotherapy University of PécsMedical SchoolClinical CenterPécs H-7624BaranyaHungary Centre for Translational Medicine Semmelweis UniversityBudapest 1085Hungary Institute of Pancreatic Diseases Semmelweis UniversityBudapest H-1083Hungary

BACKGROUND Neoadjuvant therapy is an essential modality for reducing the clinical stage of esophageal cancer;however,the superiority of neoadjuvant chemotherapy(nCT)or neoadjuvant chemoradiotherapy(nCRT)is ***,a discussion of these two modalities is *** To investigate the benefits and complications of neoadjuvant *** To address this concern,predefined criteria were established using the PICO *** independent authors performed comprehensive searches using predetermined *** analyses were performed to identify significant differences between *** publication bias was visualized using funnel *** quality of the data was evaluated using the Risk of Bias Tool 2(RoB2)and the GRADE *** Ten articles,including 1928 patients,were included for the *** difference was detected in pathological complete response(pCR)[P<0.001;odds ratio(OR):0.27;95%CI:0.16-0.46],30-d mortality(P=0.015;OR:0.4;95%CI:0.22-0.71)favoring the nCRT,and renal failure(P=0.039;OR:1.04;95%CI:0.66-1.64)favoring the *** significant differences were observed in terms of survival,local or distal recurrence,or other clinical or surgical *** result of RoB2 was moderate,and that of the GRADE approach was low or very low in almost all *** Although nCRT may have a higher pCR rate,it does not translate to greater long-term ***,nCRT is associated with higher 30-d mortality,although the specific cause for postoperative complications could not be *** the case of nCT,toxic side effects are suspected,which can reduce the quality of *** the quality of available studies,further randomized trials are required.

关键词： Neoadjuvant Chemotherapy Chemoradiotherapy Esophageal cancer Adenocarcinoma

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