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.
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.
['Song|Guo-Min|GM|', 'Tian|Xu|X|', 'Liu|Xiao-Ling|XL|', 'Chen|Hui|H|', 'Zhou|Jian-Guo|JG|', 'Bian|Wei|W|', 'Chen|Wei-Qing|WQ|']
D000368:Aged D000369:Aged, 80 and over D002294:Carcinoma, Squamous Cell D059248:Chemoradiotherapy D003131:Combined Modality Therapy D004338:Drug Combinations D004938:Esophageal Neoplasms D005260:Female D006801:Humans D008297:Male D010094:Oxonic Acid D005641:Tegafur
chemo-radiotherapy esophageal squamous cancer meta-analysis gimeraciland oteracil porassium GRADE