All-cause evaluation and prognosis analysis of patients retreated for locoregional recurrence of esophageal cancer after radical chemoradiotherapy
10.3760/cma.j.cn112271-20230712-00001
- VernacularTitle:食管癌根治性放化疗后局部区域复发再程治疗的全因性评估和预后分析
- Author:
Shuguang LI
1
;
Di WU
;
Xiaobin WANG
;
Xuehan GUO
;
Wenbin SHEN
;
Shuchai ZHU
Author Information
1. 河北医科大学第四医院放疗科，石家庄 050011
- Keywords:
Esophageal carcinoma;
Recurrence;
Retreatment;
Prognosis;
Radiotherapy
- From:
Chinese Journal of Radiological Medicine and Protection
2024;44(11):936-943
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To conduct a systematic evaluation of prognostic factors for retreatment of esophageal cancer patients with locoregional recurrence after radical chemoradiotherapy, and provide a clinical reference for selecting individualized retreatment schemes and improving their survival.Methods:A retrospective analysis was performed on the clinical data of 85 patients with esophageal cancer who experienced locoregional recurrence at least 1 year after radical radiotherapy or chemotherapy at the Department of Radiation Oncology in the Fourth Hospital of Hebei Medical University from January 2008 to December 2017. The effects of different nutritional and immune status and retreatment schemes on survival were compared, and the prognostic factors for retreatment were subjected to comprehensive subgroup analysis.Results:As of December 2021, the follow-up rate for all patients was 93%. The 1-, 2-, 3-, and 5-year overall survival rates of all patients after retreatment were 31.5%, 18.6%, 10.6%, and 6.6%, respectively. For patients who received radiotherapy or chemoradiotherapy, the 1-, 2-, 3-, and 5-year overall survival rates were 36.8%, 22.3%, 13.0% and 9.3%, respectively. Multivariable analysis showed that the time interval between the first treatment and recurrence, the retreatment schemes after recurrence, the level of serum albumin before retreatment, and the prognostic nutritional index before retreatment were independent prognostic factors for survival after retreatment ( P<0.05). Subgroup analysis was performed on the combinations of peripheral blood hemoglobin level, albumin level, and prognostic nutritional index before retreatment, as well as systemic immune inflammation index and short-term curative effect after retreatment. The results showed that the comprehensive analysis of blood routine and serum albumin indicators could accurately predict the survival after retreatment. Conclusions:The nutritional and immune status of patients with locoregional recurrence of esophageal cancer after chemoradiotherapy can be used to predict the prognosis of retreatment. The time interval between the first treatment and recurrence and the retreatment scheme significantly affect the survival after retreatment. The retreatment scheme should be rigorously evaluated and appropriately selected to improve the benefit-risk ratio.
