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Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials.
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| Zeitschriftentitel: | Journal of Clinical Oncology |
|---|---|
| Personen und Körperschaften: | , , , |
| In: | Journal of Clinical Oncology, 30, 2012, 4_suppl, S. 94-94 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
American Society of Clinical Oncology (ASCO)
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| Schlagwörter: |
| author_facet |
Njei, Basile M. Appiah, Juliet Ditah, Ivo C. Birk, John W. Njei, Basile M. Appiah, Juliet Ditah, Ivo C. Birk, John W. |
|---|---|
| author |
Njei, Basile M. Appiah, Juliet Ditah, Ivo C. Birk, John W. |
| spellingShingle |
Njei, Basile M. Appiah, Juliet Ditah, Ivo C. Birk, John W. Journal of Clinical Oncology Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. Cancer Research Oncology |
| author_sort |
njei, basile m. |
| spelling |
Njei, Basile M. Appiah, Juliet Ditah, Ivo C. Birk, John W. 0732-183X 1527-7755 American Society of Clinical Oncology (ASCO) Cancer Research Oncology http://dx.doi.org/10.1200/jco.2012.30.4_suppl.94 <jats:p> 94 </jats:p><jats:p> Background: Several trials have demonstrated better survival when surgery is combined with neoadjuvant chemotherapy and concurrent radiotherapy (CRT) in the treatment of esophageal cancer (EC). However, it is unclear whether survival benefits are counterbalanced by a poor quality of life due to the adverse effects of the combination therapy. The aim of this study was to compare the efficacy and safety of CRT plus surgery versus surgery alone. </jats:p><jats:p> Methods: Two authors independently conducted a comprehensive search of the Cochrane library PUBMED, MEDLINE, and published proceedings from major oncologic cancer meetings from January 1980 to July 2011. The titles and abstracts of all potentially relevant studies were screened for eligibility. In addition to overall outcome measures, subgroup analysis by histology of EC (squamous cell cancer [SCC] and adenocarcinoma [AC]), was also performed. Analysis was done using the fixed effect model. The Begg’s and Egger’s tests with visual inspection of the funnel plot were used to assess for population bias. </jats:p><jats:p> Results: Fifteen studies involving 1,957 patients were included in the analysis. There was an overall statistically significant increase in the 5-year survival for the CRT plus surgery group versus the surgery only group (RR 1.47, 95% CI 1.24-1.76). By histological type, only patients with SCC showed prolonged survival: RR 1.53, 95% CI 1.26-1.85. We equally found an overall significant increase in grade 3 and 4 adverse events in the CRT plus surgery group compared to the group with surgery alone (RR 1.73, 95% CI 1.15-2.60). Again, a significant increase in serious adverse events was observed only in the sub-group of patients with SCC (RR 1.81, 95% CI 1.14-2.86). There was no evidence of heterogeneity or publication bias in these analyses. </jats:p><jats:p> Conclusions: Overall, CRT plus surgery can improve long-term survival in EC patients. The results seem to be limited only to patients with SCC and not AC. However, the prolonged survival comes at the cost of poorer quality of life due to a higher incidence of adverse events. For the moment we recommend that the decision on what treatment strategy to use be based on informed patient preference. </jats:p> Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. Journal of Clinical Oncology |
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American Society of Clinical Oncology (ASCO), 2012 |
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| title |
Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_unstemmed |
Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_full |
Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_fullStr |
Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_full_unstemmed |
Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_short |
Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_sort |
chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: a systematic review of randomized control trials. |
| topic |
Cancer Research Oncology |
| url |
http://dx.doi.org/10.1200/jco.2012.30.4_suppl.94 |
| publishDate |
2012 |
| physical |
94-94 |
| description |
<jats:p> 94 </jats:p><jats:p> Background: Several trials have demonstrated better survival when surgery is combined with neoadjuvant chemotherapy and concurrent radiotherapy (CRT) in the treatment of esophageal cancer (EC). However, it is unclear whether survival benefits are counterbalanced by a poor quality of life due to the adverse effects of the combination therapy. The aim of this study was to compare the efficacy and safety of CRT plus surgery versus surgery alone. </jats:p><jats:p> Methods: Two authors independently conducted a comprehensive search of the Cochrane library PUBMED, MEDLINE, and published proceedings from major oncologic cancer meetings from January 1980 to July 2011. The titles and abstracts of all potentially relevant studies were screened for eligibility. In addition to overall outcome measures, subgroup analysis by histology of EC (squamous cell cancer [SCC] and adenocarcinoma [AC]), was also performed. Analysis was done using the fixed effect model. The Begg’s and Egger’s tests with visual inspection of the funnel plot were used to assess for population bias. </jats:p><jats:p> Results: Fifteen studies involving 1,957 patients were included in the analysis. There was an overall statistically significant increase in the 5-year survival for the CRT plus surgery group versus the surgery only group (RR 1.47, 95% CI 1.24-1.76). By histological type, only patients with SCC showed prolonged survival: RR 1.53, 95% CI 1.26-1.85. We equally found an overall significant increase in grade 3 and 4 adverse events in the CRT plus surgery group compared to the group with surgery alone (RR 1.73, 95% CI 1.15-2.60). Again, a significant increase in serious adverse events was observed only in the sub-group of patients with SCC (RR 1.81, 95% CI 1.14-2.86). There was no evidence of heterogeneity or publication bias in these analyses. </jats:p><jats:p> Conclusions: Overall, CRT plus surgery can improve long-term survival in EC patients. The results seem to be limited only to patients with SCC and not AC. However, the prolonged survival comes at the cost of poorer quality of life due to a higher incidence of adverse events. For the moment we recommend that the decision on what treatment strategy to use be based on informed patient preference. </jats:p> |
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| description | <jats:p> 94 </jats:p><jats:p> Background: Several trials have demonstrated better survival when surgery is combined with neoadjuvant chemotherapy and concurrent radiotherapy (CRT) in the treatment of esophageal cancer (EC). However, it is unclear whether survival benefits are counterbalanced by a poor quality of life due to the adverse effects of the combination therapy. The aim of this study was to compare the efficacy and safety of CRT plus surgery versus surgery alone. </jats:p><jats:p> Methods: Two authors independently conducted a comprehensive search of the Cochrane library PUBMED, MEDLINE, and published proceedings from major oncologic cancer meetings from January 1980 to July 2011. The titles and abstracts of all potentially relevant studies were screened for eligibility. In addition to overall outcome measures, subgroup analysis by histology of EC (squamous cell cancer [SCC] and adenocarcinoma [AC]), was also performed. Analysis was done using the fixed effect model. The Begg’s and Egger’s tests with visual inspection of the funnel plot were used to assess for population bias. </jats:p><jats:p> Results: Fifteen studies involving 1,957 patients were included in the analysis. There was an overall statistically significant increase in the 5-year survival for the CRT plus surgery group versus the surgery only group (RR 1.47, 95% CI 1.24-1.76). By histological type, only patients with SCC showed prolonged survival: RR 1.53, 95% CI 1.26-1.85. We equally found an overall significant increase in grade 3 and 4 adverse events in the CRT plus surgery group compared to the group with surgery alone (RR 1.73, 95% CI 1.15-2.60). Again, a significant increase in serious adverse events was observed only in the sub-group of patients with SCC (RR 1.81, 95% CI 1.14-2.86). There was no evidence of heterogeneity or publication bias in these analyses. </jats:p><jats:p> Conclusions: Overall, CRT plus surgery can improve long-term survival in EC patients. The results seem to be limited only to patients with SCC and not AC. However, the prolonged survival comes at the cost of poorer quality of life due to a higher incidence of adverse events. For the moment we recommend that the decision on what treatment strategy to use be based on informed patient preference. </jats:p> |
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| imprint_str_mv | American Society of Clinical Oncology (ASCO), 2012 |
| institution | DE-L229, DE-D275, DE-Bn3, DE-Brt1, DE-Zwi2, DE-D161, DE-Gla1, DE-Zi4, DE-15, DE-Pl11, DE-Rs1, DE-105, DE-14, DE-Ch1 |
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| spelling | Njei, Basile M. Appiah, Juliet Ditah, Ivo C. Birk, John W. 0732-183X 1527-7755 American Society of Clinical Oncology (ASCO) Cancer Research Oncology http://dx.doi.org/10.1200/jco.2012.30.4_suppl.94 <jats:p> 94 </jats:p><jats:p> Background: Several trials have demonstrated better survival when surgery is combined with neoadjuvant chemotherapy and concurrent radiotherapy (CRT) in the treatment of esophageal cancer (EC). However, it is unclear whether survival benefits are counterbalanced by a poor quality of life due to the adverse effects of the combination therapy. The aim of this study was to compare the efficacy and safety of CRT plus surgery versus surgery alone. </jats:p><jats:p> Methods: Two authors independently conducted a comprehensive search of the Cochrane library PUBMED, MEDLINE, and published proceedings from major oncologic cancer meetings from January 1980 to July 2011. The titles and abstracts of all potentially relevant studies were screened for eligibility. In addition to overall outcome measures, subgroup analysis by histology of EC (squamous cell cancer [SCC] and adenocarcinoma [AC]), was also performed. Analysis was done using the fixed effect model. The Begg’s and Egger’s tests with visual inspection of the funnel plot were used to assess for population bias. </jats:p><jats:p> Results: Fifteen studies involving 1,957 patients were included in the analysis. There was an overall statistically significant increase in the 5-year survival for the CRT plus surgery group versus the surgery only group (RR 1.47, 95% CI 1.24-1.76). By histological type, only patients with SCC showed prolonged survival: RR 1.53, 95% CI 1.26-1.85. We equally found an overall significant increase in grade 3 and 4 adverse events in the CRT plus surgery group compared to the group with surgery alone (RR 1.73, 95% CI 1.15-2.60). Again, a significant increase in serious adverse events was observed only in the sub-group of patients with SCC (RR 1.81, 95% CI 1.14-2.86). There was no evidence of heterogeneity or publication bias in these analyses. </jats:p><jats:p> Conclusions: Overall, CRT plus surgery can improve long-term survival in EC patients. The results seem to be limited only to patients with SCC and not AC. However, the prolonged survival comes at the cost of poorer quality of life due to a higher incidence of adverse events. For the moment we recommend that the decision on what treatment strategy to use be based on informed patient preference. </jats:p> Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. Journal of Clinical Oncology |
| spellingShingle | Njei, Basile M., Appiah, Juliet, Ditah, Ivo C., Birk, John W., Journal of Clinical Oncology, Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials., Cancer Research, Oncology |
| title | Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_full | Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_fullStr | Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_full_unstemmed | Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_short | Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| title_sort | chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: a systematic review of randomized control trials. |
| title_unstemmed | Chemoradiotherapy plus surgery versus surgery alone for resectable esophageal cancer: A systematic review of randomized control trials. |
| topic | Cancer Research, Oncology |
| url | http://dx.doi.org/10.1200/jco.2012.30.4_suppl.94 |