title: Chemoradiation combined with regional hyperthermia for advanced oesophageal cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Hyperthermia is an effective treatment modality that augments the anticancer effects of radiotherapy and chemotherapy. Hyperthermia-chemo-radiotherapy (HCRT) is a combination therapy that can strengthen anticancer effects through a synergistic interaction between heat, chemotherapy and radiation. Here, we carried out a systematic review and meta-analysis to evaluate the clinical efficacy and safety of chemoradiation combined with regional hyperthermia (HCRT) for oesophageal carcinoma.
  
  
  METHODS
  We conducted computer searches of foreign databases, including Cochrane Library, PubMed, EMBASE, Web of Science and Chinese databases, including CBM, CNKI and WanFang; we also retrieved other sources as supplement. All relevant randomized controlled trials (RCTs) were collected to compare HCRT and other therapies, including chemotherapy combined with radiotherapy (CRT) and radiotherapy alone (RT). After literature screening, data extraction and quality evaluation performed by appropriate criteria, the meta-analyses were conducted using RevMan 5.1 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark).
  
  
  CONCLUSIONS
  Nineteen RCTs were included, comprising 1519 patients. Meta-analysis showed that the 1-, 3-, 5- and 7-year survival, complete response and total effective rates of the HCRT group were higher than those of the CRT group; the rates of gastrointestinal reaction, leucocytopenia and radiation oesophagitis in the HCRT group were lower than those of the CRT group, indicating significant differences (P < 0·05). The 1-, 2-, 3- and 5-year survival, complete response and total effective rates of the HCRT group were higher than those of the RT group, the recurrence and distant metastasis rates of the HCRT group were lower than those of the RT group, and there were significant differences in all of the indicators (P < 0·05).
  
  
  CONCLUSIONS
  This is the first systematic review and meta-analysis to evaluate HCRT for oesophageal carcinoma. Compared with CRT or RT, HCRT can improve long-term and short-term curative effects; it is also safe and feasible. Additional high-quality and large sample size RCTs will be necessary to further demonstrate the long-term survival benefits and comprehensive safety profile of HCRT.
authors.affiliation: The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Hu
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, China.|The Second People's Hospital of Gansu Province, Lanzhou, Gansu Province, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Li
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, China.|The Second People's Hospital of Gansu Province, Lanzhou, Gansu Province, China.
authors.forename: D-H
authors.initials: DH
authors.lastname: Mi
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, China.
authors.forename: N
authors.initials: N
authors.lastname: Cao
authors.affiliation: The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
authors.forename: S-W
authors.initials: SW
authors.lastname: Zu
authors.affiliation: The Second People's Hospital of Gansu Province, Lanzhou, Gansu Province, China.
authors.forename: Z-Z
authors.initials: ZZ
authors.lastname: Wen
authors.affiliation: The Second People's Hospital of Gansu Province, Lanzhou, Gansu Province, China.
authors.forename: X-L
authors.initials: XL
authors.lastname: Yu
authors.affiliation: The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Qu
mesh_terms: D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced; D016032:Randomized Controlled Trials as Topic
keywords: chemotherapy; hyperthermia; meta-analysis; oesophageal carcinoma; radiotherapy; randomized controlled trial; systematic review