Preoperative radiotherapy for esophageal carcinoma.

摘要: BACKGROUND: The existing randomized evidence has failed to conclusively demonstrate the benefit or otherwise of preoperative radiotherapy in treating patients with potentially resectable esophageal carcinoma. OBJECTIVES: This meta-analysis aimed assess whether there is from adding prior surgery and not any pre-defined patient subgroups more less SEARCH STRATEGY: MEDLINE CancerLit searches were supplemented by information trial registers hand searching relevant meeting proceedings discussion trialists, organisations industry. search strategy was run again MEDLINE, EMBASE Cochrane Library on 30th April 2001, two years after original publication. No new trials found. re-run August 2002 2003 , Library, July 2004 2005 Library. identified these occasions. SELECTION CRITERIA: Trials eligible for inclusion this provided they carcinoma esophagus (of histological type) receive no surgery. must have used a randomization method which precluded knowledge treatment assignment completed accrual December 1993, ensure sufficient follow-up time first analysis (September 1995). DATA COLLECTION AND ANALYSIS: A quantitative using updated data individual all properly (published unpublished) comprising 1147 (971 deaths) five trials. approach improves overall survival it differentially effective defined age, sex tumour location. MAIN RESULTS: With median 9 years, group mostly squamous carcinomas, hazard ratio (HR) 0.89 (95% CI 0.78-1.01) suggests an reduction risk death 11% absolute 3% at 2 4% 5 years. result conventionally statistically significant (p=0.062). clear differences size effect sex, age tumor location apparent. AUTHORS' CONCLUSIONS: Based trials, that cancer. These results indicate if such regimens do improve survival, then likely be modest improvement around 3 4%. 2000 (90% power, 5% significance level) would needed reliably detect (from 15 20%).