Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis
Abstract Background To investigate the treatment failure pattern and factors influencing locoregional recurrence of esophageal squamous cell carcinoma (ESCC) and examine patient survival with re-irradiation (re-RT) after primary radiotherapy. Methods We retrospectively analyzed 87 ESCC patients trea...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-09-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-018-1122-y |
| _version_ | 1828763497822945280 |
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| author | Liang Hong Yun-xia Huang Qing-yang Zhuang Xue-qing Zhang Li-rui Tang Kai-xin Du Xiao-yi Lin Bu-hong Zheng Shao-li Cai Jun-xin Wu Jin-luan Li |
| author_facet | Liang Hong Yun-xia Huang Qing-yang Zhuang Xue-qing Zhang Li-rui Tang Kai-xin Du Xiao-yi Lin Bu-hong Zheng Shao-li Cai Jun-xin Wu Jin-luan Li |
| author_sort | Liang Hong |
| collection | DOAJ |
| description | Abstract Background To investigate the treatment failure pattern and factors influencing locoregional recurrence of esophageal squamous cell carcinoma (ESCC) and examine patient survival with re-irradiation (re-RT) after primary radiotherapy. Methods We retrospectively analyzed 87 ESCC patients treated initially with radiotherapy. Failure patterns were classified into regional lymph node recurrence only (LN) and primary failure with/without regional lymph node recurrence (PF). Patients received either re-RT or other treatments (non-re-RT group). Baseline covariates were balanced by a propensity score model. Overall survival (OS) and toxicities were assessed as outcomes. Results The median follow-up time was 87 months. Thirty-nine patients received re-RT. Failure pattern and re-RT were independent prognostic factors for OS (P = 0.040 and 0.015) by Cox multivariate analysis. Re-RT with concomitant chemotherapy showed no survival benefit over re-RT alone (P = 0.70). No differences in characteristics were found between the groups by Chi-square tests after propensity score matching. The Cox model showed that failure pattern and re-RT were prognostic factors with hazard ratios (HR) of 0.319 (P = 0.025) and 0.375 (P = 0.002), respectively, in the matched cohort. Significant differences in OS were observed according to failure pattern (P = 0.004) and re-RT (P < 0.001). In the re-RT and non-re-RT groups, 9.09% and 3.03% of patients experienced tracheoesophageal fistulas, and 15.15% and 3.03% of patients developed pericardial/pleural effusion, respectively (P > 0.05). The incidence of radiation pneumonitis was higher in the re-RT group (24.24% vs. 6.06%, P = 0.039), but no cases of pneumonia-related death occurred. Conclusions Re-RT improved long-term survival in patients with locoregional recurrent ESCC. Despite a high incidence of radiation pneumonitis, toxicities were tolerable. |
| first_indexed | 2024-12-11T02:00:52Z |
| format | Article |
| id | doaj.art-b4476f7a3f3a40bab987c92f64f7ba7b |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-11T02:00:52Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-b4476f7a3f3a40bab987c92f64f7ba7b2022-12-22T01:24:29ZengBMCRadiation Oncology1748-717X2018-09-011311910.1186/s13014-018-1122-ySurvival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysisLiang Hong0Yun-xia Huang1Qing-yang Zhuang2Xue-qing Zhang3Li-rui Tang4Kai-xin Du5Xiao-yi Lin6Bu-hong Zheng7Shao-li Cai8Jun-xin Wu9Jin-luan Li10Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalDepartment of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalDepartment of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalDepartment of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalDepartment of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalDepartment of Radiation Oncology, Xiamen Humanity HospitalDepartment of Radiation Oncology, Xiamen Humanity HospitalDepartment of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalBiomedical Research Center of South China, Fujian Normal UniversityDepartment of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalDepartment of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer HospitalAbstract Background To investigate the treatment failure pattern and factors influencing locoregional recurrence of esophageal squamous cell carcinoma (ESCC) and examine patient survival with re-irradiation (re-RT) after primary radiotherapy. Methods We retrospectively analyzed 87 ESCC patients treated initially with radiotherapy. Failure patterns were classified into regional lymph node recurrence only (LN) and primary failure with/without regional lymph node recurrence (PF). Patients received either re-RT or other treatments (non-re-RT group). Baseline covariates were balanced by a propensity score model. Overall survival (OS) and toxicities were assessed as outcomes. Results The median follow-up time was 87 months. Thirty-nine patients received re-RT. Failure pattern and re-RT were independent prognostic factors for OS (P = 0.040 and 0.015) by Cox multivariate analysis. Re-RT with concomitant chemotherapy showed no survival benefit over re-RT alone (P = 0.70). No differences in characteristics were found between the groups by Chi-square tests after propensity score matching. The Cox model showed that failure pattern and re-RT were prognostic factors with hazard ratios (HR) of 0.319 (P = 0.025) and 0.375 (P = 0.002), respectively, in the matched cohort. Significant differences in OS were observed according to failure pattern (P = 0.004) and re-RT (P < 0.001). In the re-RT and non-re-RT groups, 9.09% and 3.03% of patients experienced tracheoesophageal fistulas, and 15.15% and 3.03% of patients developed pericardial/pleural effusion, respectively (P > 0.05). The incidence of radiation pneumonitis was higher in the re-RT group (24.24% vs. 6.06%, P = 0.039), but no cases of pneumonia-related death occurred. Conclusions Re-RT improved long-term survival in patients with locoregional recurrent ESCC. Despite a high incidence of radiation pneumonitis, toxicities were tolerable.http://link.springer.com/article/10.1186/s13014-018-1122-yEsophageal squamous cell carcinomaLocoregional recurrenceRe-irradiationPropensity score-matched analysisOverall survival |
| spellingShingle | Liang Hong Yun-xia Huang Qing-yang Zhuang Xue-qing Zhang Li-rui Tang Kai-xin Du Xiao-yi Lin Bu-hong Zheng Shao-li Cai Jun-xin Wu Jin-luan Li Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis Radiation Oncology Esophageal squamous cell carcinoma Locoregional recurrence Re-irradiation Propensity score-matched analysis Overall survival |
| title | Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis |
| title_full | Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis |
| title_fullStr | Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis |
| title_full_unstemmed | Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis |
| title_short | Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis |
| title_sort | survival benefit of re irradiation in esophageal cancer patients with locoregional recurrence a propensity score matched analysis |
| topic | Esophageal squamous cell carcinoma Locoregional recurrence Re-irradiation Propensity score-matched analysis Overall survival |
| url | http://link.springer.com/article/10.1186/s13014-018-1122-y |
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