BACKGROUND In recent years,neoadjuvant chemotherapy(NAC)has been increasingly used in patients with resectable colorectal liver metastases.However,the efficacy and safety of NAC in the treatment of resectable colorect...BACKGROUND In recent years,neoadjuvant chemotherapy(NAC)has been increasingly used in patients with resectable colorectal liver metastases.However,the efficacy and safety of NAC in the treatment of resectable colorectal liver metastases(CRLM)are still controversial.AIM To assess the efficacy and application value of NAC in patients with resectable CRLM.METHODS We searched PubMed,Embase,Web of Science,and the Cochrane Library from inception to December 2020 to collect clinical studies comparing NAC with non-NAC.Data processing and statistical analyses were performed using Stata V.15.0 and Review Manager 5.0 software.RESULTS In total,32 studies involving 11236 patients were included in this analysis.We divided the patients into two groups,the NAC group(that received neoadjuvant chemotherapy)and the non-NAC group(that received no neoadjuvant chemotherapy).The meta-analysis outcome showed a statistically significant difference in the 5-year overall survival and 5-year disease-free survival between the two groups.The hazard ratio(HR)and 95%confidence interval(CI)were HR=0.49,95%CI:0.39-0.61,P=0.000 and HR=0.4895%CI:0.36-0.63,P=0.000.The duration of surgery in the NAC group was longer than that of the non-NAC group[standardized mean difference(SMD)=0.41,95%CI:0.01-0.82,P=0.044)].The meta-analysis showed that the number of liver metastases in the NAC group was significantly higher than that in the non-NAC group(SMD=0.73,95%CI:0.02-1.43,P=0.043).The lymph node metastasis in the NAC group was significantly higher than that in the non-NAC group(SMD=1.24,95%CI:1.07-1.43,P=0.004).CONCLUSION We found that NAC could improve the long-term prognosis of patients with resectable CRLM.At the same time,the NAC group did not increase the risk of any adverse event compared to the non-NAC group.展开更多
Background The benefit of neoadjuvant chemotherapy in the management of head and neck squamous cell carcinomas （HNSCC） still remains controversial. The aim of this meta-analysis is to evaluate the role of the neoadj...Background The benefit of neoadjuvant chemotherapy in the management of head and neck squamous cell carcinomas （HNSCC） still remains controversial. The aim of this meta-analysis is to evaluate the role of the neoadjuvant chemotherapy with the cisplatin and fluororacil （PF） regimen in enhancing the overall survival of and decreasing Iocoregional relapse and distant metastasis in HNSCC patients. Methods Medline and manual searches were performed to identify all published randomized controlled trials （RCTs） investigating the efficacy of the neoadjuvant chemotherapy with the PF regimen. Outcomes assessed by meta-analysis included Iocoregional relapse, distant metastasis, and overall survival. The odds ratio was the principle measurement of effect, which was calculated as the treatment group （chemotherapy plus Iocoregional treatment） versus the control group （Iocoregional treatment alone） and was presented as a point estimate with 95% confidence intervals （CI）. Results Eight RCTs were adopted for analysis. The meta-analysis showed that the odds ratio for the Jocoregional relapse was 0.92 （0.70-1.22, 95%CI）, which was not statistically significant. The odds ratios for distant metastasis and overall survival were 0.47 （0.33-0.68, 95% CI） and 1.28 （1.01-1.62, 95% CI） respectively, which were both statistically significant. Conclusions Neoadjuvant chemotherapy with the PF regimen in HNSCC patients has no effect on Iocoregional relapse. However, it shows a small but significant benefit in reducing distant metastasis and improving the overall survival.展开更多
基金Supported by the Natural Science Foundation of Gansu Province,China,No.18JR3RA052the Gansu Province Da Vinci Robot High End Diagnosis and Treatment Personnel Training Project+1 种基金the National Key Research and Development Program Task Book,No.2018YFC1311506the Lanzhou Talent Innovation and Entrepreneurship Project Task Contract,No.2016-RC-56.
文摘BACKGROUND In recent years,neoadjuvant chemotherapy(NAC)has been increasingly used in patients with resectable colorectal liver metastases.However,the efficacy and safety of NAC in the treatment of resectable colorectal liver metastases(CRLM)are still controversial.AIM To assess the efficacy and application value of NAC in patients with resectable CRLM.METHODS We searched PubMed,Embase,Web of Science,and the Cochrane Library from inception to December 2020 to collect clinical studies comparing NAC with non-NAC.Data processing and statistical analyses were performed using Stata V.15.0 and Review Manager 5.0 software.RESULTS In total,32 studies involving 11236 patients were included in this analysis.We divided the patients into two groups,the NAC group(that received neoadjuvant chemotherapy)and the non-NAC group(that received no neoadjuvant chemotherapy).The meta-analysis outcome showed a statistically significant difference in the 5-year overall survival and 5-year disease-free survival between the two groups.The hazard ratio(HR)and 95%confidence interval(CI)were HR=0.49,95%CI:0.39-0.61,P=0.000 and HR=0.4895%CI:0.36-0.63,P=0.000.The duration of surgery in the NAC group was longer than that of the non-NAC group[standardized mean difference(SMD)=0.41,95%CI:0.01-0.82,P=0.044)].The meta-analysis showed that the number of liver metastases in the NAC group was significantly higher than that in the non-NAC group(SMD=0.73,95%CI:0.02-1.43,P=0.043).The lymph node metastasis in the NAC group was significantly higher than that in the non-NAC group(SMD=1.24,95%CI:1.07-1.43,P=0.004).CONCLUSION We found that NAC could improve the long-term prognosis of patients with resectable CRLM.At the same time,the NAC group did not increase the risk of any adverse event compared to the non-NAC group.
文摘Background The benefit of neoadjuvant chemotherapy in the management of head and neck squamous cell carcinomas （HNSCC） still remains controversial. The aim of this meta-analysis is to evaluate the role of the neoadjuvant chemotherapy with the cisplatin and fluororacil （PF） regimen in enhancing the overall survival of and decreasing Iocoregional relapse and distant metastasis in HNSCC patients. Methods Medline and manual searches were performed to identify all published randomized controlled trials （RCTs） investigating the efficacy of the neoadjuvant chemotherapy with the PF regimen. Outcomes assessed by meta-analysis included Iocoregional relapse, distant metastasis, and overall survival. The odds ratio was the principle measurement of effect, which was calculated as the treatment group （chemotherapy plus Iocoregional treatment） versus the control group （Iocoregional treatment alone） and was presented as a point estimate with 95% confidence intervals （CI）. Results Eight RCTs were adopted for analysis. The meta-analysis showed that the odds ratio for the Jocoregional relapse was 0.92 （0.70-1.22, 95%CI）, which was not statistically significant. The odds ratios for distant metastasis and overall survival were 0.47 （0.33-0.68, 95% CI） and 1.28 （1.01-1.62, 95% CI） respectively, which were both statistically significant. Conclusions Neoadjuvant chemotherapy with the PF regimen in HNSCC patients has no effect on Iocoregional relapse. However, it shows a small but significant benefit in reducing distant metastasis and improving the overall survival.
