Investigation on the dominant population of esophageal cancer patients treated with radical radiotherapy combined with different methods of chemotherapy
10.19405/j.cnki.issn1000-1492.2022.07.029
- Author:
Yuechen Xu
1
;
Zhongxuan Gui
1
;
Han Qian
1
;
Hongyan Wang
1
;
Fan Wang
1
Author Information
1. Dept of Radiotherapy，First Affiliated Hospital of Anhui Medical University，Hefei 230022
- Publication Type:Journal Article
- Keywords:
esophageal cancer;
concurrent chemoradiotherapy;
sequential chemoradiotherapy;
dominant popula- tion
- From:
Acta Universitatis Medicinalis Anhui
2022;57(7):1166-1170，1176
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the short-term efficacy and long-term survival rate of radical radiotherapy combined with concurrent chemotherapy and sequential chemotherapy in esophageal cancer patients, and to investigate the dominant population of esophageal cancer patients who were suitable for concurrent chemoradiotherapy.
Methods:Two hundred and eighty patients with esophageal cancer treated with radical radiotherapy from July 2015 to June 2020 were recruited, including 140 patients with concurrent chemotherapy and 140 patients with sequential chemotherapy. The short-term efficacy and long-term survival rate between two groups were compared. Kaplan-Meier survival analysis, Logistic regression analysis and Cox regression analysis were used to analyze the risk factors for short-term efficacy, long-term survival rate and the dominant population suitable for concurrent chemoradiotherapy.
Results:There was no significant difference about the short-term efficacy between the two groups(P>0.05), but in patients with TNM<Ⅳ, the complete remission(CR) rate in concurrent chemotherapy group(18.6%) was higher than that in sequential chemotherapy group(7.7%)(χ2=5.079,P=0.024). Among patients with midpiece esophageal cancer, CR rate in concurrent chemotherapy group was higher than that in sequential chemotherapy group(20.0%vs6.7%, χ2=4.498,P=0.034). The CR rate in patients with TNM<Ⅳ and midpiece esophageal cancer was higher in concurrent chemotherapy group(21.2%) than that in sequential chemotherapy group(2.2%)(χ2=7.459,P=0.006). Results of Kaplan-Meier survival analysis showed that the total survival time(4.0 years) and the 3-year survival rate(73.2%) in concurrent chemotherapy group were higher than those in sequential chemotherapy group(2.8 years, 24.2%)(P<0.000 1,P<0.000 1). Logistic regression analysis showed that patients with TNM<Ⅳ and midpiece esophageal cancer(OR=11.85) had higher CR rate in group with concurrent chemoradiotherapy(P<0.05). Cox regression analysis showed that concurrent chemoradiotherapy was a protective factor for death in patients with esophageal cancer(HR=0.448,P<0.000 1). Concurrent chemoradiotherapy was also a protective factor for death in patients with TNM<Ⅳ(HR=0.286), with midpiece esophageal cancer(HR=0.499), with midpiece esophageal cancer and TNM<Ⅳ(HR=0.218), with non-esophageal involvement all around(HR=0.384), with TNM<Ⅳ and non-esophageal involvement all around(HR=0.197), and with TNM<Ⅳ and non-ulcer type(HR=0.266,P<0.05).
Conclusion:Compared to patients with esophageal cancer treated with sequential chemoradiotherapy, patients treated with concurrent chemoradiotherapy have higher CR rate and long-term survival rate. Patients with TNM<Ⅳ, midpiece tumor location, non-esophageal involvement all around and non-ulcer type esophageal are the superior population for concurrent chemoradiotherapy.
- Full text:2025022710324197695食管癌患者适合同步放化疗的优势人群探讨_徐月辰.pdf
