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What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis
The standard radiation dose 50.4 Gy with concurrent chemotherapy for localized inoperable esophageal cancer as supported by INT-0123 trail is now being challenged since a radiation dose above 50 Gy has been successfully administered with an observable dose–response relationship and insignificant unt...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Impact Journals LLC
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687672/ https://www.ncbi.nlm.nih.gov/pubmed/29179502 http://dx.doi.org/10.18632/oncotarget.18760 |
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author | Chen, Yong Zhu, Hui-Ping Wang, Tao Sun, Chang-Jiang Ge, Xiao-Lin Min, Ling-Feng Zhang, Xian-Wen Jia, Qing-Qing Yu, Jie Yang, Jian-Qi Allgayer, Heike Abba, Mohammed L. Zhang, Xi-Zhi Sun, Xin-Chen |
author_facet | Chen, Yong Zhu, Hui-Ping Wang, Tao Sun, Chang-Jiang Ge, Xiao-Lin Min, Ling-Feng Zhang, Xian-Wen Jia, Qing-Qing Yu, Jie Yang, Jian-Qi Allgayer, Heike Abba, Mohammed L. Zhang, Xi-Zhi Sun, Xin-Chen |
author_sort | Chen, Yong |
collection | PubMed |
description | The standard radiation dose 50.4 Gy with concurrent chemotherapy for localized inoperable esophageal cancer as supported by INT-0123 trail is now being challenged since a radiation dose above 50 Gy has been successfully administered with an observable dose–response relationship and insignificant untoward effects. Therefore, to ascertain the treatment benefits of different radiation doses, we performed a meta-analysis with 18 relative publications. According to our findings, a dose between 50 and 70 Gy appears optimal and patients who received ≥ 60 Gy radiation had a significantly better prognosis (pooled HR = 0.78, P = 0.004) as compared with < 60 Gy, especially in Asian countries (pooled HR = 0.75, P = 0.003). However, contradictory results of treatment benefit for ≥ 60 Gy were observed in two studies from Western countries, and the pooled treatment benefit of ≥ 60 Gy radiation was inconclusive (pooled HR = 0.86, P = 0.64). There was a marginal benefit in locoregional control in those treated with high dose (> 50.4/51 Gy) radiation when compared with those treated with low dose (≤ 50.4/51 Gy) radiation (pooled OR = 0.71, P = 0.06). Patients that received ≥ 60 Gy radiation had better locoregional control (OR = 0.29, P = 0.001), and for distant metastasis control, neither the > 50.4 Gy nor the ≥ 60 Gy treated group had any treatment benefit as compared to the groups that received ≤ 50.4 Gy and < 60 Gy group respectively. Taken together, a dose range of 50 to 70 Gy radiation with CCRT is recommended for non-operable EC patients. A dose of ≥ 60 Gy appears to be better in improving overall survival and locoregional control, especially in Asian countries, while the benefit of ≥ 60 Gy radiation in Western countries still remains controversial. |
format | Online Article Text |
id | pubmed-5687672 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Impact Journals LLC |
record_format | MEDLINE/PubMed |
spelling | pubmed-56876722017-11-20 What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis Chen, Yong Zhu, Hui-Ping Wang, Tao Sun, Chang-Jiang Ge, Xiao-Lin Min, Ling-Feng Zhang, Xian-Wen Jia, Qing-Qing Yu, Jie Yang, Jian-Qi Allgayer, Heike Abba, Mohammed L. Zhang, Xi-Zhi Sun, Xin-Chen Oncotarget Meta-Analysis The standard radiation dose 50.4 Gy with concurrent chemotherapy for localized inoperable esophageal cancer as supported by INT-0123 trail is now being challenged since a radiation dose above 50 Gy has been successfully administered with an observable dose–response relationship and insignificant untoward effects. Therefore, to ascertain the treatment benefits of different radiation doses, we performed a meta-analysis with 18 relative publications. According to our findings, a dose between 50 and 70 Gy appears optimal and patients who received ≥ 60 Gy radiation had a significantly better prognosis (pooled HR = 0.78, P = 0.004) as compared with < 60 Gy, especially in Asian countries (pooled HR = 0.75, P = 0.003). However, contradictory results of treatment benefit for ≥ 60 Gy were observed in two studies from Western countries, and the pooled treatment benefit of ≥ 60 Gy radiation was inconclusive (pooled HR = 0.86, P = 0.64). There was a marginal benefit in locoregional control in those treated with high dose (> 50.4/51 Gy) radiation when compared with those treated with low dose (≤ 50.4/51 Gy) radiation (pooled OR = 0.71, P = 0.06). Patients that received ≥ 60 Gy radiation had better locoregional control (OR = 0.29, P = 0.001), and for distant metastasis control, neither the > 50.4 Gy nor the ≥ 60 Gy treated group had any treatment benefit as compared to the groups that received ≤ 50.4 Gy and < 60 Gy group respectively. Taken together, a dose range of 50 to 70 Gy radiation with CCRT is recommended for non-operable EC patients. A dose of ≥ 60 Gy appears to be better in improving overall survival and locoregional control, especially in Asian countries, while the benefit of ≥ 60 Gy radiation in Western countries still remains controversial. Impact Journals LLC 2017-06-28 /pmc/articles/PMC5687672/ /pubmed/29179502 http://dx.doi.org/10.18632/oncotarget.18760 Text en Copyright: © 2017 Chen et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Meta-Analysis Chen, Yong Zhu, Hui-Ping Wang, Tao Sun, Chang-Jiang Ge, Xiao-Lin Min, Ling-Feng Zhang, Xian-Wen Jia, Qing-Qing Yu, Jie Yang, Jian-Qi Allgayer, Heike Abba, Mohammed L. Zhang, Xi-Zhi Sun, Xin-Chen What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis |
title | What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis |
title_full | What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis |
title_fullStr | What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis |
title_full_unstemmed | What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis |
title_short | What is the optimal radiation dose for non-operable esophageal cancer? Dissecting the evidence in a meta-analysis |
title_sort | what is the optimal radiation dose for non-operable esophageal cancer? dissecting the evidence in a meta-analysis |
topic | Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687672/ https://www.ncbi.nlm.nih.gov/pubmed/29179502 http://dx.doi.org/10.18632/oncotarget.18760 |
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