| Objectives:To collect all randomized or quasi-randomized controlled trials,which was published and unpublished,relevant to EBR+B in the treatment of patients with inoperable esophageal cancer was performed to look at its efficiency and safety. Clarify the benefits of its,and to provide not only the best available evidence for clinical practice,but also the principle and guidance for relevant clinical studies.Methods:according Cochrane upper gastrointestinal and pancreatic diseases group developed search strategies,The Cochrane library(4th Quarter 2007),Pubmed(1977 to 12,2007),Embase(1974 to 12,2007)and CBM(1978-2007),VIP(1989-2007), CNKI(1994-2007)adopt corresponding Chinese search-words were searched by computer,"Chinese Journal of Radiation Oncology," et al 12 major Chinese oncology journals were searched by manual,with Google,Medical Martix Internet search engines find relevant literature.Randomized or quasi-randomized controlled trials compared EBR+B with EBR alone in the treatment of patients with inoperable esophageal cancer were included,Two reviewers assessed Trial methodological quality and extracted data independently.Discussion or the third party when needed resolved the disagreement.Types of outcome measures with Primary outcome:control rate after treatment;1,3,5-years survival rates and Secondry outcomes:Tumor regrowth;Tumor metastasis;quality of life;complication(Radiation esophagitis Perforation;Radiation pneumonia;haemorrage;benign esophageal stricture).Statistical analysis using Cochrane upper gastrointestinal and pancreatic diseases collaboration provided RevMan4.2.10.For dichotomous outcomes(e.g.survival rates,tumor regrowth,etc)results will be expressed as odds ratio(OR),Where continuous scales of measurement are used to assess the effects of treatment,the weighted mean difference(MD)will be used,or the standardised mean difference(SMD)if different scales have been used.The effects of both will use 95%confidence interval (Confidence Interval,CI)to show. Results:Up to December 2007,a total of 14 published randomized controlled trials, 1400 patients,was collected,methods quality of all trials were C class,the results of Meta-analysis showed that:EBR+B significantly higher than EBR alone in control rate after treatment and 1,3-years survival rate,the difference was significant(control rate after treatment,OR1.93 95%CI1.07-1.39,P=0.03,1-year survival rate OR1.84, 95%CI1.44-2.36,P＜0.00001;3-years survival rate OR1.45,95%CI 1.12-1.89,P= 0.005),5-years survival rate in two group no significant difference(OR1.26,95%CI 0.02-1.94,P=0.29).compared with the EBR,tumor regrowth rate in the observation group decreased,it has significant difference(OR 0.56,95%CI0.35-0.90, P=0.02),tumor metastasis rate no significant difference in the two groups (OR1.19,95%CI0.78-1.81,P=0.43),as for the occurrence rate of radiation esophagitis,bleeding,benign esophageal stenosis in the EBR+B higher than the EBR,it has significant difference(radiation esophagitis:OR 1.91,95%CI 1.03-3.54, P=0.04;Bleeding:OR3.04,95%CI 1.51-6.15,P=0.002;benign esophageal stenosis: OR1.68,95%CI 1.07-2.64,P=0.02);while esophageal perforation and esophageal ulcer no significant difference between the two groups(perforation:OR0.92,95%CI 0.52-1.62,P=0.77;esophageal ulcer:OR1.43,95%CI 0.82-2.47,P=0.20); radiation pneumonitis in the EBR was higher than EBR+B with significant difference (OR0.12,95%CI 0.04-0.40,P=0.0005).all the trials did not report the quality of life of the patients.Conclusion:EBR+B is better than EBR alone in the patient's control rate after treatment and 1,3-years survival rate,meanwhile reduce the toumor regrowth.As for sately,EBR+B increased the occurrence rate of radiation esophagitis,bleeding, benign esophageal stenosis compared more than EBR alone,but the incidence of radiation pneumonitis was lower in EBR+B.However,it should be cautious of interpreting this conclusion due to the general low methodological quality.In addition,more rationally designed and strictly executed RCTs with large samples will be necessary.
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