Esophageal carcinoma (EC) is one of the major malignant diseases worldwide. Surgery alone cannot obtain satisfactory effects in patients with EC. Neoadjuvant chemoradiotherapy has been a hotspot for EC treatment research. Several related randomized controlled trials (RCTs) have been published, but opinions vary among clinicians as to the therapeutic effect of the new method. It remains uncertain whether patients with resectable EC can benefit from neoadjuvant chemoradiotherapy.
A research article to be published on December 21, 2009 in the World Journal of Gastroenterology addresses this question. The research team from China selected eleven randomized controlled trials (RCTs) including 1308 patients. The reuslts showed neoadjuvant chemoradiotherapy significantly improved the overall survival compared with surgery alone. Histological subgroup analysis indicated that esophageal squamous cell carcinoma did not benefit from neoadjuvant chemoradiotherapy.
Their meta-analysis suggest that patients with esophageal adenocarcinoma (EAC) may be the real beneficiaries of the treatment protocol. Compared with patients treated by surgery alone, patients receiving neoadjuvant chemoradiotherapy more likely obtained complete resection and had lower local cancer recurrence. Neoadjuvant chemoradiotherapy was connected with a little higher mortality after surgery. But it did not increase the incidence of postoperative complications.
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Jin HL, Zhu H, Ling TS, Zhang HJ, Shi RH. Neoadjuvant chemoradiotherapy for resectable esophageal carcinoma: A meta-analysis. World J Gastroenterol 2009; 15(47): 5983-5991 www.wjgnet.com/1007-9327/15/5983.asp