Concurrent chemo-radiotherapy with S-1 as an alternative therapy for elderly Chinese patients with non-metastatic esophageal squamous cancer: evidence based on a systematic review and meta-analysis
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Guo-Min Song1,*, Xu Tian2,*, Xiao-Ling Liu2,*, Hui Chen2,*, Jian-Guo Zhou3, Wei Bian4 and Wei-Qing Chen2
1 Department of Nursing, Tianjin Hospital, Tianjin, China
2 Department of Gastroenterology, Chongqing Cancer Institute & Hospital & Cancer Center, Chongqing, China
3 Department of Oncology, Affiliated Hospital to Zunyi Medical University, Zunyi, China
4 Ophthalmology Department, Southwest Hospital, Third Military Medical University, Chongqing, China
* These authors have contributed equally to this work
Wei-Qing Chen, email:
Keywords: esophageal squamous cancer, gimeraciland oteracil porassium, chemo-radiotherapy, meta-analysis, GRADE
Received: October 20, 2016 Accepted: March 08, 2017 Published: March 16, 2017
Objective: This systematic review and meta-analysis aims to systematically assess the effects of concurrent chemo-radiotherapy (CRT) compared with radiotherapy (RT) alone for elderly Chinese patients with non-metastatic esophageal squamous cancer.
Methods: We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), China Biomedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) databases. We retrieved randomized controlled trials on concurrent CRT with Gimeraciland Oteracil Porassium (S-1) compared with RT alone for aged Chinese patients with non-metastatic esophageal squamous cancer performed until August 2016.
Results: Eight eligible studies involving 536 patients were subjected to meta-analysis. As a response rate measure, a relative risk (RR) of 1.37 [95% confidence intervals (CIs): 1.24, 1.53; P = 0.00], which reached statistical significance, was estimated when concurrent CRT with S-1 was performed compared with RT alone. Sensitivity analysis on response rate confirmed the robustness of the pooled result. The RR values of 1.44 (95% CIs: 1.22, 1.70; P = 0.00) and 1.77 (95% CIs: 1.26, 2.48; P = 0.00) estimated for 1- and 2-year survival rate indices, respectively, were also statistically significant. The incidence of adverse events was similar in both groups.
Conclusion: This review concluded that concurrent CRT with S-1 can improve the efficacy and prolong the survival period of elderly Chinese patients with non-metastatic esophageal squamous cancer and does not significantly increase the acute adverse effects of RT alone.
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