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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Neoadjuvant chemoradiotherapy for esophageal carcinoma: a meta-analysis

Review published: 2005.

Bibliographic details: Greer S E, Goodney P P, Sutton J E, Birkmeyer J D.  Neoadjuvant chemoradiotherapy for esophageal carcinoma: a meta-analysis. Surgery 2005; 137(2): 172-177. [PubMed: 15674197]

Quality assessment

This review compared the effectiveness of neoadjuvant chemoradiotherapy (NCRT) followed by surgery with surgery alone for patients with oesophageal cancer. The authors concluded that NCRT was associated with a small nonsignificant improvement in survival, but further research is needed. Limitations in review methods and reporting mean that it is not possible to independently endorse these conclusions. Full critical summary


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.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2012 University of York.

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