| Objective: Concurrent Chemoradiotherapy(CCRT)is the recommended therapy for unresectable locally advanced esophageal cancer.The radiation dose has always been controversial.The INT0123 test showed that there was no local or survival benefit when the radiotherapy dose was increased from50.4Gy to 64.8Gy during concurrent chemoradiotherapy,so 50.4Gy was considered as the standard dose for radical concurrent chemoradiotherapy.However,this conclusion is increasingly being challenged.In Asia,especially in China,most centers use the irradiation dose of 60 Gy or above,and the therapeutic effect is mostly reported to be satisfactory with tolerable side effects.Therefore,we carried out this meta-analysis to clarify the comparison of efficacy and safety between Higher Dose Radiotherapy(HD-RT)and Standard Dose Radiotherapy(SD-RT)in CCRT in the context of today’s precise treatment techniques.Methods:Systematic literature retrieval was conducted in Pub Med and CNKI databases by computer.The data were meta-analyzed using stata11.1,and the study endpoint was 5 years Overall survival(OS),3 years OS,and The incidence of radioactive toxic events was compared.Results: The long-term survival of HD-RT group was better than that of SD-RT group(HR = 0.78,95%CI: 0.72-0.84,P <0.05).5-year OS rate risk ratio(RR)= 1.25;95% 101:1.14-1.37,P <0.05),But 3-year OS rate comparison showed no statistical significance(RR=0.92,95%CI:0.79-1.08,P >0.05);There was no significant difference in the incidence of radiation esophagitis,radiation pneumonia and blood toxicity between the two groups(RR=0.91,95%CI:0.80,1.02,P >0.05;RR=0.92,95%CI:0.70-1.22,P >0.05;RR=0.91,95%CI:0.81-1.01,P >0.05).Conclusions:Compared with SD-RT,HD-RT based on precision radiotherapy tended to improve long-term survival in CCRT of esophageal squamous cell carcinoma and did not increase the incidence of toxic events. |
PDF Full Text Request