Document Detail


Neoadjuvant chemoradiotherapy for esophageal carcinoma: a meta-analysis.
MedLine Citation:
PMID:  15674197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The effectiveness in improving survival of neoadjuvant chemoradiotherapy (NCRT) in patients undergoing surgery for esophageal carcinoma remains unclear. METHODS: MEDLINE, the Cochrane Database of Systematic Reviews, BIOSIS Previews, and other resources were searched from January 1966 through January 2003. Randomized trials were selected on the basis of study design (NCRT followed by surgery vs surgery alone). Of 21 potential studies identified by abstract review, 6 (29%) met the inclusion criteria. RESULTS: Across 6 studies, a total of 374 patients underwent NCRT followed by surgery and 364 underwent surgery alone. In 5 of the 6 studies in our meta-analysis, there was a small, non-statistically significant trend toward improved survival with NCRT. Only 1 study demonstrated a statistically significant benefit to NCRT. In our summary measure for all 6 studies, we found a small, non-statistically significant trend toward improved long-term survival in the NCRT followed by surgery group (relative risk of death in the NCRT group [RR], 0.86; 95% confidence interval [CI], 0.74 to 1.01; P = .07). CONCLUSIONS: NCRT followed by surgery is associated with a small, non-statistically significant improvement in overall survival. Whether this benefit is sufficient to warrant the considerable expense and risks associated with NCRT should be the subject of future larger randomized trials.
Authors:
Sarah E Greer; Philip P Goodney; John E Sutton; John D Birkmeyer
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Surgery     Volume:  137     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-27     Completed Date:  2005-03-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  172-7     Citation Subset:  AIM; IM    
Affiliation:
Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. sarah.greer@hitchcock.org
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Squamous Cell / mortality,  therapy
Esophageal Neoplasms / mortality,  therapy*
Humans
Neoadjuvant Therapy
Survival Rate
Comments/Corrections
Comment In:
Surgery. 2005 Feb;137(2):178-9   [PMID:  15674198 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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