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放化疗与单独化疗对ⅣB期食管鳞癌生存期影响的比较
李胜磊1, 王昆仑1, 杨晖1, 李炳旭2, 李艳1, 袁翎1
1郑州大学附属肿瘤医院放疗科,郑州 450003; 2安阳市肿瘤医院放疗科,安阳 455001
The effect of combined chemoradiotherapy versus chemotherapy alone on the survival of ⅣB stage esophageal squamous cell carcinoma
Li Shenglei1, Wang Kunlun1, Yang Hui1, Li Bingxu2, Li Yan1, Yuan Ling1
1Department of Radiation oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450003,China; 2Department of Radiation oncology, Anyang Cancer Hospital, Anyang 455001,China
Abstract：Objective To investigate the survival benefit of radiotherapy on the basis of systemic treatment for stage ⅣB esophageal squamous cell carcinoma (ESCC). Methods Based on inclusion and exclusion criteria, we collected the treatment information of 298 patients with newly diagnosed stage ⅣB ESCC admitted to Affiliated Cancer Hospital of Zhengzhou University from January 2016 to February 2021. All patients were divided into two groups based on treatment: early radiotherapy intervention group (CRT group,n=197) and salvage radiotherapy intervention or no intervention group (CT group,n=101). Propensity score matching (PSM) was used to balance baseline characteristics between two groups. Kaplan‐Meier method was used to calculate the survival rate and log‐rank was used to test the difference. Cox model was used to analyze the multivariate prognosis. Results In the CRT and CT groups, the Objective response rate (ORR) and disease control rate (DCR) were 52.8% vs. 31.5%(P=0.006) and 98.9% vs. 85.4%(P=0.001) respectively, and the 1‐, 2‐ and 3‐year survival rates were 74.2% vs. 52.8%、31.5% vs. 10.1% and 15.7% vs. 2.2%, respectively. Median progression‐free survival (PFS) was 8.5 months (95%CI: 6.7‐10.3 months) vs. 4.4 months (95%CI: 3.5‐5.3 months)(P<0.001). Median overall survival (OS) were 17.1 months (95%CI: 14.9‐19.3 months) vs. 12.7 months (95%CI: 8.0‐17.4 months)(P<0.001). The difference of adverse reactions was mainly in hematology. Conclusions For newly diagnosed stage ⅣB patients with ESCC, radiotherapy should be combined with systemic therapy as early as possible. It yields longer PFS and OS, and effectively improves dysphagia. Adverse reactions are tolerated. Further validation is recommended in larger prospective studies.
Li Shenglei,Wang Kunlun,Yang Hui et al. The effect of combined chemoradiotherapy versus chemotherapy alone on the survival of ⅣB stage esophageal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2022, 31(10): 884-890.
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