Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy
Background The improvement efficacy of consolidation chemotherapy after definitive concurrent chemotherapy and radio-therapy (CCRT) on the prognosis of patients with locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In addition, there is a lack of nutritional risk scr...
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| Format: | Article |
| Language: | zho |
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Chinese General Practice Publishing House Co., Ltd
2023-10-01
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| Series: | Zhongguo quanke yixue |
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| Online Access: | https://www.chinagp.net/fileup/1007-9572/PDF/20230202.pdf |
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| author | YAN Ke, WEI Wanyi, LI Shuguang, YAO Weinan, DONG Jing, WANG Xiaobin, ZHANG Xueyuan, YANG Jie, SHEN Wenbin, ZHU Shuchai |
| author_facet | YAN Ke, WEI Wanyi, LI Shuguang, YAO Weinan, DONG Jing, WANG Xiaobin, ZHANG Xueyuan, YANG Jie, SHEN Wenbin, ZHU Shuchai |
| author_sort | YAN Ke, WEI Wanyi, LI Shuguang, YAO Weinan, DONG Jing, WANG Xiaobin, ZHANG Xueyuan, YANG Jie, SHEN Wenbin, ZHU Shuchai |
| collection | DOAJ |
| description | Background The improvement efficacy of consolidation chemotherapy after definitive concurrent chemotherapy and radio-therapy (CCRT) on the prognosis of patients with locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In addition, there is a lack of nutritional risk screening tools which can consistently and accurately predict the survival of patients with esophageal cancer. Objective To investigate the effect of consolidation chemotherapy on the prognosis of patients with locally advanced ESCC receiving definitive CCRT. Methods A total of 223 patients with ESCC who received definitive CCRT in the department of radiotherapy, the Fourth Hospital of Hebei Medical University from January 2013 to December 2018 were selected as the research objects and divided into the simple CCRT group (n=87) and combined consolidation chemotherapy group (n=136) according to chemoradiotherapy regimen adopted by the patients. General data, ECOG score, tumor site, tumor length, TNM stage, radiotherapy dose, irradiation mode and chemotherapy regimen of the included patients were collected by electronic medical record system. Nutritional Risk Screening 2002 (NRS 2002) was used to score the nutritional status of the patients before chemoradiotherapy. Efficacy evaluation was performed within 1 month after CCRT, including complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). Patients were followed up by telephone (completed by the follow-up center) and outpatient review until 2022-09-30, with overall survival (OS), local relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS) collected. Survival curves of OS, LRRFS and DMFS were plotted by Kaplan-Meier method and compared by Log-rank test. Univariate and multivariate Cox risk regression models were used to explore the influencing factors of patient prognosis. Results There was no significant difference in baseline data between the simple CCRT group and combined consolidation chemotherapy group (P>0.05). There was no significant difference in the rates of OS, LRRFS and DMFS between the two groups (χ2=1.942, 0.743, 1.272; P=0.163, 0.389, 0.259). There were significant differences in the rates of OS, LRRFS and DMFS between patients with NRS 2002 score <3 (n=172) and patients with NRS 2002 score≥3 (n=51) before treatment (χ2=6.585, 4.858, 7.814; P=0.010, 0.028, 0.005). Multivariate Cox proportional hazard regression analysis showed that TNM stage and NRS 2002 score were influencing factors of OS and DMFS (P<0.05), irradiation mode was an influencing factor of LRRFS and DMFS (P<0.05), and clinical efficacy was an influencing factors of OS, LRRFS and DMFS (P<0.05). Stratified analysis showed that in patients with TNM stage Ⅱ and clinical efficacy of CR, the OS rates in the combined consolidation chemotherapy group (n=74, n=33) were significantly higher than those in the simple CCRT group (n=43, n=28), with statistically significant differences (χ2=4.811, 3.932; P=0.028, 0.047) . Conclusion Consolidation chemotherapy did not improve the prognosis of stageⅡ-Ⅲ ESCC patients after definitive CCRT, but may bring survival benefits for patients with early clinical stage, good response and nutritional status. As a nutritional risk screening tool, NRS 2002 has significant predictive value for the long-term survival of patients with locally advanced ESCC after chemoradiotherapy. |
| first_indexed | 2024-04-24T11:48:13Z |
| format | Article |
| id | doaj.art-9da79cf1904b4aca83fdb7f3333f0f16 |
| institution | Directory Open Access Journal |
| issn | 1007-9572 |
| language | zho |
| last_indexed | 2024-04-24T11:48:13Z |
| publishDate | 2023-10-01 |
| publisher | Chinese General Practice Publishing House Co., Ltd |
| record_format | Article |
| series | Zhongguo quanke yixue |
| spelling | doaj.art-9da79cf1904b4aca83fdb7f3333f0f162024-04-09T08:44:31ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722023-10-0126303772377910.12114/j.issn.1007-9572.2023.0202Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapyYAN Ke, WEI Wanyi, LI Shuguang, YAO Weinan, DONG Jing, WANG Xiaobin, ZHANG Xueyuan, YANG Jie, SHEN Wenbin, ZHU Shuchai01. Department of Radiotherapy, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China;2. Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, ChinaBackground The improvement efficacy of consolidation chemotherapy after definitive concurrent chemotherapy and radio-therapy (CCRT) on the prognosis of patients with locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In addition, there is a lack of nutritional risk screening tools which can consistently and accurately predict the survival of patients with esophageal cancer. Objective To investigate the effect of consolidation chemotherapy on the prognosis of patients with locally advanced ESCC receiving definitive CCRT. Methods A total of 223 patients with ESCC who received definitive CCRT in the department of radiotherapy, the Fourth Hospital of Hebei Medical University from January 2013 to December 2018 were selected as the research objects and divided into the simple CCRT group (n=87) and combined consolidation chemotherapy group (n=136) according to chemoradiotherapy regimen adopted by the patients. General data, ECOG score, tumor site, tumor length, TNM stage, radiotherapy dose, irradiation mode and chemotherapy regimen of the included patients were collected by electronic medical record system. Nutritional Risk Screening 2002 (NRS 2002) was used to score the nutritional status of the patients before chemoradiotherapy. Efficacy evaluation was performed within 1 month after CCRT, including complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). Patients were followed up by telephone (completed by the follow-up center) and outpatient review until 2022-09-30, with overall survival (OS), local relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS) collected. Survival curves of OS, LRRFS and DMFS were plotted by Kaplan-Meier method and compared by Log-rank test. Univariate and multivariate Cox risk regression models were used to explore the influencing factors of patient prognosis. Results There was no significant difference in baseline data between the simple CCRT group and combined consolidation chemotherapy group (P>0.05). There was no significant difference in the rates of OS, LRRFS and DMFS between the two groups (χ2=1.942, 0.743, 1.272; P=0.163, 0.389, 0.259). There were significant differences in the rates of OS, LRRFS and DMFS between patients with NRS 2002 score <3 (n=172) and patients with NRS 2002 score≥3 (n=51) before treatment (χ2=6.585, 4.858, 7.814; P=0.010, 0.028, 0.005). Multivariate Cox proportional hazard regression analysis showed that TNM stage and NRS 2002 score were influencing factors of OS and DMFS (P<0.05), irradiation mode was an influencing factor of LRRFS and DMFS (P<0.05), and clinical efficacy was an influencing factors of OS, LRRFS and DMFS (P<0.05). Stratified analysis showed that in patients with TNM stage Ⅱ and clinical efficacy of CR, the OS rates in the combined consolidation chemotherapy group (n=74, n=33) were significantly higher than those in the simple CCRT group (n=43, n=28), with statistically significant differences (χ2=4.811, 3.932; P=0.028, 0.047) . Conclusion Consolidation chemotherapy did not improve the prognosis of stageⅡ-Ⅲ ESCC patients after definitive CCRT, but may bring survival benefits for patients with early clinical stage, good response and nutritional status. As a nutritional risk screening tool, NRS 2002 has significant predictive value for the long-term survival of patients with locally advanced ESCC after chemoradiotherapy.https://www.chinagp.net/fileup/1007-9572/PDF/20230202.pdfesophageal cancers|carcinoma, squamous cell|chemoradiotherapy|synchronous chemoradiotherapies|consolidation chemotherapy|prognosis|root cause analysis |
| spellingShingle | YAN Ke, WEI Wanyi, LI Shuguang, YAO Weinan, DONG Jing, WANG Xiaobin, ZHANG Xueyuan, YANG Jie, SHEN Wenbin, ZHU Shuchai Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy Zhongguo quanke yixue esophageal cancers|carcinoma, squamous cell|chemoradiotherapy|synchronous chemoradiotherapies|consolidation chemotherapy|prognosis|root cause analysis |
| title | Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy |
| title_full | Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy |
| title_fullStr | Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy |
| title_full_unstemmed | Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy |
| title_short | Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy |
| title_sort | effect of consolidation chemotherapy on prognosis of stageii iii esophageal squamous cell carcinoma patients treated with definitive concurrent chemotherapy and radio therapy |
| topic | esophageal cancers|carcinoma, squamous cell|chemoradiotherapy|synchronous chemoradiotherapies|consolidation chemotherapy|prognosis|root cause analysis |
| url | https://www.chinagp.net/fileup/1007-9572/PDF/20230202.pdf |
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