Propensity score matching analytical results of the impacts of different radiotherapy modalities on the prognosis of patients with esophageal squamous cell carcinoma
10.3760/cma.j.cn112271-20231218-00214
- VernacularTitle:不同放疗模式对食管鳞癌患者预后影响的倾向评分匹配分析结果
- Author:
Shuguang LI
1
;
Youmei LI
1
;
Xiaohan ZHAO
1
;
Jinrui XU
1
;
Wenzhao DENG
1
;
Ke YAN
1
;
Shuchai ZHU
1
;
Wenbin SHEN
1
Author Information
1. 河北医科大学第四医院放疗科 050011
- Publication Type:Journal Article
- Keywords:
Esophageal squamous cell carcinoma;
Radiotherapy;
Irradiation modality;
Propensity score matching analysis;
Prognosis
- From:
Chinese Journal of Radiological Medicine and Protection
2024;44(12):1006-1012
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impacts of two radiotherapy modalities, elective nodal irradiation (ENI) and involved-field irradiation (IFI), on the prognosis of patients with clinical T 1~4N 0M 0 esophageal squamous cell carcinoma (ESCC) treated with definitive (chemotherapy) radiotherapy. Methods:A retrospective analysis was conducted on the prognosis of 324 patients with clinical T 1-4N 0M 0 ESCC, focusing on the impacts of ENI and IFI on the prognosis of these patients. Propensity score matching (PSM) analysis was performed based on the different composition ratios of the two groups, and stratified analysis was conducted for patients of different stages. Results:All the patients presented a median overall survival (OS) of 33.1 months (95% CI: 28.1-38.1) and a median progression-free survival (PFS) of 22.3 months (95% CI: 18.2-26.4). There were 97 patients in the ENI group and 227 patients in the IFI group. The ENI group exhibited higher OS and PFS than the IFI group ( χ2 = 4.31, 4.10, P < 0.05). After 1∶1 PSM analysis, each of the groups contained 75 cases. Multivariate analysis revealed that independent factors affecting patient OS included patient age, gross tumor volume (GTV), and irradiation modality ( χ2 = 7.93, 5.88, 4.59, P < 0.05) and PFS ( χ2 = 7.10, 5.26, 3.39, P < 0.05). Further stratified analysis indicated that ENI yielded significantly better efficacy than IFI for patients with cT 1 and T 2stage ESCC ( χ2 = 9.41, 7.88, P < 0.05). However, this advantage was not found in T 3 and T 4 patients ( P > 0.05). There was no statistically significant difference in the incidence of radiation esophagitis and radiation pneumonia between both groups ( P > 0.05). Conclusions:Patients with clinical T 1-4N 0M 0 ESCC who undergone definitive (chemotherapy) radiotherapy may benefit from ENI, particularly those in the cT 1 and cT 2 stages, for whom ENI is recommended for definitive radiotherapy.
