Survival Comparision of Three-dimensional Radiotherapy Alone vs. Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

被引:12
|
作者
Zhang, An-Du [1 ,2 ]
Su, Xiao-Hua [3 ]
Shi, Gao-Feng [1 ,2 ]
Han, Chun [1 ,2 ]
Wang, Lan [1 ,2 ]
Liu, Hui [1 ,2 ]
Zhang, Jun [1 ,2 ]
Zhang, Ruo-Hui [1 ,2 ]
机构
[1] Hebei Med Univ, Affiliated Hosp 4, 12 Jiankang Rd, Shijiazhuang 050011, Hebei, Peoples R China
[2] Hebei Prov Tumor Hosp, 12 Jiankang Rd, Shijiazhuang 050011, Hebei, Peoples R China
[3] Hebei Gen Hosp, Shijiazhuang, Hebei, Peoples R China
关键词
Carcinoma; Squamous cell; Chemoradiotherapy; Esophageal neoplasms; Overall survival; QUALITY-OF-LIFE; CONCURRENT CHEMORADIOTHERAPY; RANDOMIZED-TRIAL; CONFORMAL RADIOTHERAPY; CANCER; CHEMOTHERAPY; CISPLATIN; JUNCTION; THERAPY; REGIMEN;
D O I
10.1016/j.arcmed.2020.04.013
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background and Objective. To compare the survival of esophageal squamous cell carcinoma (ESCC) patients who received chemoradiotherapy (CRT) or radiotherapy (RT) alone. Methods. A total of 753 well-matched patients were enrolled. A total of 299 patients were treated with CRT, and 454 patients were treated with RT alone. Propensity score matching (PSM) was performed with the R project. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to assess differences in survival. Results. The response rate was 99.0% with CRT and 98.3% with RT alone (p = 0.651). The 1-, 3-, 5- and 10 year overall survival (OS) rates were as follows: 72.2, 40.1, 30.7 and 13.9% with CRT, 68.1, 35.2%, 23.3 and 12.5% with RT alone (p = 0.033); 73.4, 40.1, 31.0 and 16.1% with concurrent chemoradiotherapy (CCRT); and 68.1, 35.2, 23.3 and 12.5% with RT alone (p = 0.028). There was no significant difference in OS between the CCRT group and the sequential chemoradiotherapy (SCRT) group (p = 0.527). Consolidation chemotherapy (CCT) after CCRT led to a significant increase in the OS rate compared with no CCT after CCRT (p = 0.003). Compared with the OS of patients who received 1-2 cycles of CCT, the OS of patients who received 3-4 cycles of CCT was significantly improved (p = 0.011). Acute toxic effects were more severe in the CRT, but no significant differences in late reactions. CRT exhibited more appetite loss and fatigue symptoms than RT alone, and dysphagia of CRT relief more obviously. The CRT group had a significantly lower rate of local control failure than the RT alone group (p = 0.019). Conclusions. For patients with ESCC, CRT led to a significantly improved OS compared to RT alone, and this trend was more obvious with CCRT. CCT after CCRT prolonged OS, especially in patients who received at least 2 cycles of CCT. CRT can reduce the deaths due to local control failure compared to RT alone. (C) 2020 IMSS. Published by Elsevier Inc.
引用
收藏
页码:419 / 428
页数:10
相关论文
共 50 条
  • [21] Concurrent chemoradiotherapy alone is feasible for esophageal squamous cell carcinoma patients not suitable for surgery
    Chen, Yongshun
    Wang, Jun
    RADIOTHERAPY AND ONCOLOGY, 2018, 129 (01) : 182 - 182
  • [22] Feasibility and efficiency of concurrent chemoradiotherapy with a single agent or double agents vs radiotherapy alone for elderly patients with esophageal squamous cell carcinoma: Experience of two centers
    Huang, Chunyue
    Zhu, Yujia
    Li, Qiwen
    Zhang, Wenwen
    Liu, Hui
    Zhang, Weijun
    Hu, Yonghong
    Yuan, Yawei
    Liu, Mengzhong
    CANCER MEDICINE, 2019, 8 (01): : 28 - 39
  • [23] Efficacy and Safety of Radiotherapy Combined with Chemoimmunotherapy vs. Chemoimmunotherapy Alone as First-Line Treatment for Advanced Esophageal Squamous Cell Carcinoma with Oligorecurrence
    Lv, X.
    Wang, Y.
    Ai, J.
    Wang, Q.
    Wang, J.
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2024, 120 (02): : E493 - E493
  • [24] Radiotherapy Combined with Chemoimmunotherapy vs. Chemoimmunotherapy Alone as First-Line Treatment for Advanced Esophageal Squamous Cell Carcinoma with Oligometastasis at Initial Diagnosis
    Lv, X.
    Wang, S.
    Zhang, W.
    Pang, Q.
    Lin, Q.
    Wu, Y.
    Hui, Z.
    Liu, Y.
    Cheng, Y.
    Liu, Q.
    Wang, J.
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2024, 120 (02): : E493 - E494
  • [25] Clusterin as a predictor for chemoradiotherapy sensitivity and patient survival in esophageal squamous cell carcinoma
    He, Li-Ru
    Liu, Meng-Zhong
    Li, Bin-Kui
    Rao, Hui-Lan
    Liao, Yi-Ji
    Zhang, Lan-Jun
    Guan, Xin-Yuan
    Zeng, Yi-Xin
    Xie, Dan
    CANCER SCIENCE, 2009, 100 (12) : 2354 - 2360
  • [26] Radiotherapy Alone or Concurrent Chemoradiation for Esophageal Squamous Cell Carcinoma in Elderly Patients
    Zhao, Lina
    Zhou, Yongchun
    Pan, Haitao
    Yin, Yutian
    Chai, Guangjin
    Mu, Yunfeng
    Xiao, Feng
    Lin, Steven H.
    Shi, Mei
    JOURNAL OF CANCER, 2017, 8 (16): : 3242 - 3250
  • [27] Comparison of Radiation Esophagitis Associated with Morning vs. Evening Radiotherapy in Patients with Esophageal Squamous Cell Carcinoma
    Xiang, G.
    Xing, Y.
    Zhang, C.
    Yin, Y.
    Zhao, L.
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2024, 120 (02): : E499 - E499
  • [28] Radiotherapy Alone or Concurrent Chemoradiation for Esophageal Squamous Cell Carcinoma in Elderly Patients
    Zhao, L.
    Zhou, Y. C.
    Pan, H.
    Yin, Y.
    Lin, S. H.
    Shi, M.
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2017, 99 (02): : E205 - E206
  • [29] Long-term outcomes of three-dimensional conformal radiotherapy-based and intensity-modulated radiotherapy-based concurrent chemoradiotherapy in patients with thoracic esophageal squamous cell carcinoma
    Chang, C-L.
    Wu, S-Y.
    ANNALS OF ONCOLOGY, 2019, 30
  • [30] Three-dimensional organoids reveal therapy resistance of esophageal squamous cell carcinoma cells
    Kita, Yoshiaki
    Kijima, Takashi
    Nakagawa, Hiroshi
    Mori, Shinnichiro
    Tanabe, Hiroshi
    Uchikado, Yasuto
    Sasaki, Ken
    Omoto, Itaru
    Arigami, Takaaki
    Yanagita, Shigehiro
    Matsushita, Daisuke
    Maemura, Kousei
    Natsugoe, Shoji
    CANCER SCIENCE, 2018, 109 : 881 - 881