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Can involved-field irradiation replace elective nodal irradiation in chemoradiotherapy for esophageal cancer? A systematic review and meta-analysis

Authors Wang X, Miao C, Chen Z, Li W, Yuan S, Yu J, Hu X

Received 15 December 2016

Accepted for publication 17 March 2017

Published 11 April 2017 Volume 2017:10 Pages 2087—2095


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Carlos E Vigil

Xiaoyue Wang,1,* Chuanwang Miao,2,3,* Zhen Chen,4 Wanhu Li,5 Shuanghu Yuan,3 Jinming Yu,3 Xudong Hu3

1Department of Surgery, Shandong Cancer Hospital Affiliated to Shandong University, 2Department of Oncology, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, 3Department of Radiation Oncology, 4Department of Medical Oncology, 5Department of Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong Province, People’s Republic of China

*These authors contributed equally to this work

Abstract: Chemoradiotherapy is the most common treatment for inoperable esophageal cancer. However, there is no consensus on the delineation of the clinical target volume. Elective nodal irradiation (ENI) is recommended for inoperable esophageal cancer. A few studies have reported a decrease in the incidence of radiation-related toxicity of involved-field irradiation (IFI) for esophageal cancer. A systematic review and pooled analysis were performed to determine whether IFI in definitive chemoradiotherapy was more beneficial than ENI for esophageal cancer. The results showed no significant differences in the overall survival and local control rates between the IFI and ENI arms. Meanwhile, the incidences of esophageal and lung toxicities were significantly decreased in the IFI arm. These results suggest that IFI is a feasible treatment option for locally advanced esophageal cancer, especially to minimize irradiation-related toxicity.

Keywords: chemoradiotherapy, esophageal cancer, involved-field irradiation, elective nodal irradiation, meta-analysis

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