title: Concurrent neoadjuvant chemoradiotherapy could improve survival outcomes for patients with esophageal cancer: a meta-analysis based on random clinical trials.
abstract: BACKGROUND
  The long-term survival benefit of concurrent neoadjuvant chemoradiotherapy in patients with resectable esophageal cancer remains controversial. In the present study, we conducted a meta-analysis to assess these effectiveness.
  
  
  METHODS
  We searched for most relevant studies published up to the end of August 2016, using Pubmed and web of knowledge. And additional articles were identified from previous meta-analysis. The hazard ratio (HR, for overall survival and progression free survival) or risk ratio (RR, for R0 resection) with its corresponding 95 % confidence interval (CI) were used to assess the pooled effect.
  
  
  RESULTS
  Twelve articles including 1756 patients were included in the meta-analysis. Concurrent neoadjuvant chemoradiotherapy followed by surgery was associated with significantly improved overall survival (HR=0.76 , 95% CI= 0.68-0.86), progression survival (HR =0.69, 95% CI= 0.59-0.81), and R0 resection rate(RR =1.17, 95% CI= 1.03-1.33). Subgroup analysis suggested that concurrent neoadjuvant chemoradiotherapy could improve overall survival outcome for squamous cell carcinoma (HR=0.73, 95%CI=0.61-0.88) but not those for adenocarcinoma (HR=0.72, 95%CI=0.48-1.04).
  
  
  CONCLUSIONS
  Our findings suggested that concurrent neoadjuvant chemoradiotherapy was associated with a significant survival benefit in patients with esophageal cancer.
authors.affiliation: Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, Henan, China.
authors.forename: Baoxing
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, China.
authors.forename: Yacong
authors.initials: Y
authors.lastname: Bo
authors.affiliation: Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, Henan, China.
authors.forename: Kunlun
authors.initials: K
authors.lastname: Wang
authors.affiliation: Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, Henan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, Henan, China.
authors.forename: Xiance
authors.initials: X
authors.lastname: Tang
authors.affiliation: Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, Henan, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, Henan, China.
authors.forename: Erjiang
authors.initials: E
authors.lastname: Zhao
authors.affiliation: Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor Hospital, Zhengzhou, Henan, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Yuan
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy / Q000379:methods*; D016896:Treatment Outcome
keywords: R0 resection rate; esophageal cancer; neoadjuvant concurrent chemoradiotherapy; overall survival; progression-free survival