Prognosis of surgery combined with different adjuvant therapies in esophageal cancer treatment: a network meta-analysis
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Shenglei Li1,*, Hongtao Liu2,*, Changying Diao1, Xiaohui Wang1, Ming Gao3, Zongming Li4, Lijie Song3, Xianzheng Gao1, Jing Han1, Feng Wang3, Wencai Li1 and Xinwei Han4
1Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 50000, China
2Laboratory for Cell Biology, College of Life Sciences of Zhengzhou University, Zhengzhou, Henan, 450001, China
3Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450000, China
4Department of Interventional Therapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450000, China
*These authors have contributed equally to this work
Feng Wang, email: email@example.com
Xinwei Han, email: firstname.lastname@example.org
Keywords: esophageal cancer, surgery, adjuvant therapies, chemotherapy, radiotherapy
Received: September 09, 2016 Accepted: February 20, 2017 Published: March 14, 2017
This network meta-analysis was conducted to assess whether the efficacy of surgery with adjuvant therapies, including radiotherapy (RT+S), chemotherapy (CT+S), and chemoradiotherapy (CRT+S) have better performance in esophageal cancer treatment and management. PubMed and EMBASE were used to search for relevant trials. Both conventional pair-wise and network meta-analyses were carried out. The surface under the cumulative ranking curve (SUCRA) was used to rank interventions based on the efficacy of the treatment method. As for 3-year overall survival (OS), CRT+S showed the highest efficacy (CRT+S vs. surgery: HR=0.81, 95% CrI =0.73-0.90; CRT+S vs. CT+S: HR=0.82, 95% CrI =0.70-0.95; CRT+S vs. RT+S: HR=0.77, 95% CrI =0.62-0.95). For disease-free survival, CRT+S showed efficacy over CT+S ((HR =0.70, 95% CrI =0. 59-0.83). In conclusion, CRT+S showed a better performance for survival outcomes and ranks best among all therapies. The results of our study can provide guidance for medical decisions and treatment options that may help clinical practitioners improve the efficacy of EC treatment.
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