Table 3. Comprehensive systematic review and meta-analysis of neoadjuvant chemoradiotherapy versus chemotherapy.

Reference	Pathological complete response (%)			3-yr survival (%)					3-yr survival (%)			R0 resection (%)
	CRS	C		CRS (ADC)	CRS (SCC)	C (ADC)	C (SCC)		CRS	C		CRS	C
Deng HY, et al. (2016) (14)	22.1	3.7		46.3	56.8	41.0	42.8		52	42		89.1	76.9

Meta-analysis: pathological complete response rate is significantly improved with neoadjuvant chemoradiotherapy compared to chemotherapy alone. [RR: 5.71; 95% CI, (3.06–10.65); P<0.001]; 3-yr survival significantly improved in patient with SCC undergoing neoadjuvant chemoradiotherapy compared to chemotherapy alone. [RR: 1.31; 95% CI, (1.10–1.58); P=0.003]; 3-yr survival not significantly improved in patients with ADC undergoing neoadjuvant chemoradiotherapy compared to chemotherapy alone. [RR: 1.13; 95% CI, (0.88–1.45); P=0.34]; 3-yr survival significantly improved in patients undergoing neoadjuvant chemotherapy (all cell types) compared to chemotherapy alone. [RR: 1.23; 95% CI, (1.06–1.43); P=0.006]; R0 resection rate significantly improved with neoadjuvant chemoradiotherapy compared to neoadjuvant chemotherapy alone. [RR:1.15; 95% CI, (1.08–1.23); P<0.001]. Accumulating evidence suggests that esophageal SCC responds better to CRS, whereas esophageal ADC responds best to neoadjuvant chemotherapy alone to avoid adverse effects of radiation.