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Postoperative adjuvant chemotherapy versus chemoradiotherapy for node-positive esophageal squamous cell carcinoma: a propensity score-matched analysis.
Radiation Oncology ( IF 3.3 ) Pub Date : 2020-05-24 , DOI: 10.1186/s13014-020-01557-9
Qifeng Wang 1, 2 , Jinyi Lang 1 , Tao Li 1 , Lin Peng 3 , Wei Dai 3 , Yinchun Jiang 3 , Tianpeng Xie 3 , Qiang Fang 3 , Yi Wang 1, 2 , Lei Wu 1, 2 , Bangrong Cao 2 , Yongtao Han 3
Affiliation  

BACKGROUND AND PURPOSE After esophagectomy, adjuvant chemotherapy (S + CT) and adjuvant chemoradiotherapy (S + CRT) can improve survival in patients with node-positive resectable esophageal cancer. However, we are not aware of any studies that directly compared these adjuvant treatments. This study aimed to compare S + CT and S + CRT for patients with esophageal cancer. MATERIALS AND METHODS We retrospectively identified patients with node-positive esophageal squamous cell carcinoma who underwent S + CT or S + CRT at Sichuan Cancer Hospital during 2008-2017. The patients' characteristics were compared, as well as their overall survival (OS) and disease-free survival (DFS) outcomes. Propensity score matching was used to create balanced patient groups according to adjuvant treatment, and a Cox proportional hazards model was used to identify factors that predicted the survival outcomes. RESULTS The 859 eligible patients underwent S + CRT (250 patients, 29.1%) or S + CT (609 patients, 70.9%). After propensity score matching (247 patients per group), the 5-year OS rates were 41.8% for S + CRT and 26.8% for S + CT (p = 0.028), and the 5-year DFS rates were 37.2% for S + CRT and 25.5% for S + CT (p = 0.012). Multivariate Cox regression analysis of the matched samples revealed that, relative to the S + CT group, the S + CRT group had better OS (hazard ratio: 0.71, 95% CI: 0.56-0.91; p = 0.006) and DFS (hazard ratio: 0.70, 95% CI: 0.56-0.88; p = 0.002). CONCLUSION Among patients with node-positive resectable esophageal squamous cell carcinoma, S + CRT was associated with better OS than S + CT. A multicenter randomized clinical trial is warranted to confirm these findings.

中文翻译:

淋巴结阳性食管鳞癌术后辅助化疗与放化疗的倾向性得分匹配分析。

背景与目的食管切除术后,辅助化疗(S + CT)和辅助放化疗(S + CRT)可以提高淋巴结阳性可切除食管癌患者的生存率。但是,我们尚无直接比较这些辅助治疗的研究。这项研究旨在比较食管癌患者的S + CT和S + CRT。材料与方法我们回顾性分析了2008-2017年间在四川省癌症医院接受S + CT或S + CRT的淋巴结阳性食管鳞状细胞癌患者。比较了患者的特征以及他们的总生存期(OS)和无病生存期(DFS)。倾向得分匹配用于根据辅助治疗建立平衡的患者组,并使用Cox比例风险模型来识别预测生存结果的因素。结果859例符合条​​件的患者接受了S + CRT(250例患者,占29.1%)或S + CT(609例患者,占70.9%)。倾向评分匹配后(每组247例患者),S + CRT的5年OS率为41.8%,S + CT的5年OS率为26.8%(p = 0.028),S +的5年DFS率为37.2%。 CRT为25.5%(S + CT)(p = 0.012)。匹配样本的多变量Cox回归分析显示,相对于S + CT组,S + CRT组的OS(危险比:0.71,95%CI:0.56-0.91; p = 0.006)和DFS(危险比)更好。 :0.70,95%CI:0.56-0.88; p = 0.002)。结论在淋巴结阳性的可切除食管鳞状细胞癌患者中,S + CRT的OS优于S + CT。
更新日期:2020-05-24
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