Long-term efficacy and safety of simultaneous integrated boost radiotherapy in non-operative esophageal squamous cell carcinoma: a multicenter retrospective data analysis (3JECROG R-05)
10.3760/cma.j.cn112152-20190412-00234
- VernacularTitle:同步加量放疗治疗不可手术食管鳞癌的远期疗效及安全性：泛京津冀食管肿瘤多中心协作组多中心回顾性研究(3JECROG R-05)
- Author:
Xiaomin WANG
1
;
Lan WANG
;
Xin WANG
;
Junqiang CHEN
;
Chen LI
;
Wencheng ZHANG
;
Xiaolin GE
;
Wenbin SHEN
;
Miaomiao HU
;
Qianqian YUAN
;
Yonggang XU
;
Chongli HAO
;
Zhiguo ZHOU
;
Shuai QIE
;
Na LU
;
Chun HAN
;
Qingsong PANG
;
Ping WANG
;
Xinchen SUN
;
Kaixian ZHANG
;
Gaofeng LI
;
Ling LI
;
Miaoling LIU
;
Yadi WANG
;
Xueying QIAO
;
Shuchai ZHU
;
Zongmei ZHOU
;
Yidian ZHAO
;
Zefen XIAO
Author Information
1. 河南省安阳市肿瘤医院放疗科 455000
- Keywords:
Esophageal neoplasms;
Simultaneous boost radiotherapy;
Prognosis;
Adverse reaction;
Propensity score matching
- From:
Chinese Journal of Oncology
2021;43(8):889-896
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the survival benefits and treatment related toxic effects of simultaneous integrated boost intensity-modulated radiotherapy (SIB-RT) for non-operative esophageal squamous cell carcinoma patients.Methods:The data of 2 132 ESCC patients who were not suitable for surgery or rejected operation, and underwent radical radiotherapy from 2002 to 2016 in 10 hospitals of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG) were analyzed. Among them, 518 (24.3%) cases underwent SIB (SIB group) and 1 614 (75.7%) cases did not receive SIB (No-SIB group). The two groups were matched with 1∶2 according to propensity score matching (PSM) method (caliper value=0.02). After PSM, 515 patients in SIB group and 977 patients in No-SIB group were enrolled. Prognosis and treatment related adverse effects of these two groups were compared and the independent prognostic factor were analyzed.Results:The median follow-up time was 61.7 months. Prior to PSM, the 1-, 3-, and 5-years overall survival (OS) rates of SIB group were 72.2%, 42.8%, 35.5%, while of No-SIB group were 74.3%, 41.4%, 31.9%, respectively ( P=0.549). After PSM, the 1-, 3-, and 5-years OS rates of the two groups were 72.5%, 43.4%, 36.4% and 75.3%, 41.7%, 31.6%, respectively ( P=0.690). The univariate survival analysis of samples after PSM showed that the lesion location, length, T stage, N stage, TNM stage, simultaneous chemoradiotherapy, gross tumor volume (GTV) and underwent SIB-RT or not were significantly associated with the prognosis of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Cox model multivariate regression analysis showed lesion location, TNM stage, GTV and simultaneous chemoradiotherapy were independent prognostic factors of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Stratified analysis showed that, in the patients whose GTV volume≤50 cm 3, the median survival time of SIB and No-SIB group was 34.7 and 30.3 months ( P=0.155), respectively. In the patients whose GTV volume>50 cm 3, the median survival time of SIB and No-SIB group was 16.1 and 20.1 months ( P=0.218). The incidence of radiation esophagitis and radiation pneumonitis above Grade 3 in SIB group were 4.3% and 2.5%, significantly lower than 13.1% and 11% of No-SIB group ( P<0.001). Conclusions:The survival benefit of SIB-RT in patients with locally advanced esophageal carcinoma is not inferior to non-SIB-RT, but without more adverse reactions, and shortens the treatment time. SIB-RT can be used as one option of the radical radiotherapy for locally advanced esophageal cancer.
