title: Survival after neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for resectable esophageal carcinoma: A meta-analysis.
abstract: BACKGROUND
  The efficacy of surgery alone for patients with locally advanced esophageal cancer (EC) is still unsatisfactory. Presently, induction therapy followed by surgery is the standard treatment. Preoperative chemotherapy (CT) and chemoradiation (CRT) are proven effective induction therapies; however, few sample studies have addressed these treatments, thus, their superiority remains uncertain. We performed a systemic review and meta analysis to test the hypothesis that induction CRT prior to surgery could improve survival compared with induction CT alone.
  
  
  METHODS
  A comprehensive search of PubMed and the Ovid database for relevant studies comparing EC patients undergoing resection after treatment with induction CT alone or induction CRT was conducted. Hazard ratios (HR) and 95% confidence intervals (95% CI) were extracted from these studies to provide pooled estimates of the effect of induction therapy on overall survival.
  
  
  RESULTS
  Five studies met the criteria for analysis. Statistical analysis demonstrated a survival benefit of induction CRT compared with induction CT alone (HR0.73, 95% CI 0.61-0.89; P = 0.002). Further analysis showed that induction CRT perioperative mortality and complication rates were higher than for induction CT alone (HR 2.96, 95% CI 1.38-6.37; HR1.6, 95% CI 1.30-1.98; P = 0.01, respectively).
  
  
  CONCLUSIONS
  Published evidence comparing the different efficacies of induction CT and induction CRT is sparse, with few samples of adenocarcinoma. This analysis supports the view that, compared with induction CT, induction CRT could achieve a long-term survival benefit in EC patients.
authors.affiliation: The First Department of Thoracic Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing China.
authors.forename: Mengying
authors.initials: M
authors.lastname: Fan
authors.affiliation: The First Department of Thoracic Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Lin
authors.affiliation: The First Department of Thoracic Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing China.
authors.forename: Jianhong
authors.initials: J
authors.lastname: Pan
authors.affiliation: The First Department of Thoracic Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing China.
authors.forename: Wanpu
authors.initials: W
authors.lastname: Yan
authors.affiliation: The First Department of Thoracic Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing China.
authors.forename: Liang
authors.initials: L
authors.lastname: Dai
authors.affiliation: The First Department of Thoracic Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing China.
authors.forename: Luyan
authors.initials: L
authors.lastname: Shen
authors.affiliation: The First Department of Thoracic Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) Peking University Cancer Hospital & Institute Beijing China.
authors.forename: Keneng
authors.initials: K
authors.lastname: Chen
keywords: Esophageal cancer; induction chemoradiotherapy; induction chemotherapy; overall survival