Systematic overview of preoperative (neoadjuvant) chemoradiotherapy trials in oesophageal cancer: evidence of a radiation and chemotherapy dose response.

摘要: Abstract Background and purpose Numerous trials have shown that pathological complete response (pCR) following preoperative chemoradiotherapy (CRT) surgery for oesophageal cancer is associated with improved survival. However, different radiotherapy doses fractionations chemotherapy drugs, scheduling were used, which may account the differences in observed pCR survival rates. A dose–response relationship exist between dose pCR. Patients methods Trials using a single regimen (5FU, cisplatin or mitomycin C-based) providing information on patient numbers, age, resection rates eligible. The endpoint used was covariates analysed prescribed dose, dose×dose per fraction, treatment time, C) median age of patients within trial. model multivariate logistic regression. Results Twenty-six included (1335 patients) 311 (24%) achieved probability increasing ( P =0.006), 5FU =0.003) =0.018). Increasing time =0.035) =0.019) reduced estimated α / β ratio 4.9Gy (95% confidence interval (CI) 1.5–17Gy) lost day 0.59Gy CI 0.18–0.99Gy). One gram square metre to be equivalent 1.9Gy 0.8–5.2Gy) radiation 100mg/m 2 7.2Gy 2.1–28Gy). Mitomycin C did not appear influence =0.60). Conclusions There evidence dose-response protocol radiotherapy, Additional significant factors