■本系统综述和荟萃分析旨在研究有或没有放疗的新辅助免疫化疗[NIC(R)T]与传统新辅助疗法相比的作用。没有免疫治疗[NC(R)T]。
■对于早期食管癌患者,建议行NCRT手术切除。然而,在新辅助治疗后进行根治性手术时,在术前新辅助治疗中加入免疫治疗是否能改善患者的预后尚不确定.
■我们搜索了PubMed,WebofScience,Embase,和CochraneCentral数据库,以及国际会议摘要。结果包括R0,病理完全缓解(pCR),主要病理反应(mPR),总生存率(OS)和无病生存率(DFS)。
■我们纳入了2019年至2022年间发表的86项研究的5,034名患者的数据。我们发现NICRT和NCRT在pCR或mPR率方面没有显着差异。两者都比NICT好,NCT显示最低的反应率。新辅助免疫治疗在1年OS和DFS方面相对于传统新辅助治疗具有显著优势,NICT的疗效优于其他三种治疗方法。在R0率方面,四种新辅助治疗之间没有显着差异。
■在四种新辅助治疗方式中,NICRT和NCRT的pCR和mPR率最高。4种处理的R0率无显著差异。在新辅助治疗中加入免疫治疗可改善1年OS和DFS,与其他三种模式相比,NICT的比率最高。
■https://inplasy.com/inplasy-2022-12-0060/,标识符INPLASY2022120060。
This systematic
review and meta-analysis aimed to investigate the role of neoadjuvant immunochemotherapy with or without radiotherapy [NIC(R)T] compared to traditional neoadjuvant therapies, without immunotherapy [NC(R)T].
NCRT followed by surgical resection is recommended for patients with early-stage esophageal cancer. However, it is uncertain whether adding immunotherapy to preoperative neoadjuvant therapy would improve patient outcomes when radical surgery is performed following neoadjuvant therapy.
We searched PubMed, Web of Science, Embase, and Cochrane Central databases, as well as international conference abstracts. Outcomes included R0, pathological complete response (pCR), major pathological response (mPR), overall survival (OS) and disease-free survival (DFS) rates.
We included data from 5,034 patients from 86 studies published between 2019 and 2022. We found no significant differences between NICRT and NCRT in pCR or mPR rates. Both were better than NICT, with NCT showing the lowest response rate. Neoadjuvant immunotherapy has a significant advantage over traditional neoadjuvant therapy in terms of 1-year OS and DFS, with NICT having better outcomes than any of the other three treatments. There were no significant differences among the four neoadjuvant treatments in terms of R0 rates.
Among the four neoadjuvant treatment modalities, NICRT and NCRT had the highest pCR and mPR rates. There were no significant differences in the R0 rates among the four treatments. Adding immunotherapy to neoadjuvant therapy improved 1-year OS and DFS, with NICT having the highest rates compared to the other three modalities.
https://inplasy.com/inplasy-2022-12-0060/, identifier INPLASY2022120060.