Abstract
AIM: To compare the efficacy and safety of docetaxel chemotherapy combined with radiotherapy versus radiotherapy only in the treatment of esophageal cancer.
METHODS: Controlled trials that evaluated clinical effects of docetaxel chemotherapy combined with radiotherapy versus radiotherapy alone in the treatment of esophageal cancer were electronically searched from the CBM (1978-2011) and CNKI (1979-2011) databases, and the relevant published and unpublished data and their references in Chinese were also searched manually. The data were extracted and the methodological quality of the incorporated research was evaluated by two reviewers independently. The RevMan 5.1 software was used for meta-analysis.
RESULTS: Ten controlled trials involving 378 patients were included. Meta-analysis showed that compared with radiotherapy alone, docetaxel chemotherapy combined with radiotherapy was associated with better complete remission [RR = 2.12, 95%confidenceinterval (CI) (1.39, 3.25), P = 0.0005], short-term efficacy [RR = 3.56, 95%CI (1.97, 6.42), P < 0.0001], 1-year survival rate [RR = 2.64, 95%CI (1.17, 5.97), P = 0.02], and significantly improved grade 1 gastrointestinal reactions [RR = 0.37, 95%CI (0.17, 0.80), P = 0.01]. There were no significant differences in the rate of partial remission [RR = 1.05, 95%CI (0.69, 1.59), P = 0.83], 3-year survival rate [RR = 2.21, 95%CI (1.16, 4.22), P = 0.02], grades 0, 1, 2 and 3 gastrointestinal reactions [RR = 0.78, 95%CI (0.35, 1.73), P = 0.55; RR = 2.05, 95%CI (0.92, 4.59), P = 0.08; RR = 1.08, 95%CI (0.49, 2.39), P = 0.84; RR = 1.45, 95%CI (0.54, 3.90), P = 0.46], grades 0, 1, 2, 3 and 4 hematologic toxicities [RR = 0.55, 95%CI (0.26, 1.13), P = 0.10; RR = 1.00, 95%CI (0.48, 2.10), P = 1.00; RR = 1.26, 95%CI (0.58, 2.74), P = 0.56; RR = 1.29, 95%CI (0.48, 3.51), P = 0.61; RR = 3.09, 95%CI (0.31, 30.50), P = 0.33], and grades 2 and 3 esophageal mucosal reactions [RR = 1.20, 95%CI (0.60, 2.39), P = 0.60; RR = 1.27, 95%CI (0.49, 3.30), P = 0.63].
CONCLUSION: Docetaxel chemotherapy combined with radiotherapy is better than radiotherapy only in the treatment of esophageal cancer in terms of the overall curative effect. Because of a small number of studies in the incorporated research, the above conclusion is still validated by carrying out reasonably more randomized controlled trials with the multiple center sample.
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