Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma
Abstract Background The optimal treatment for esophageal squamous cell carcinoma (ESCC) patients with postoperative recurrence remains controversial. We aimed to evaluate the effects of radiotherapy (RT) and chemoradiotherapy (CRT) on postoperative recurrence in ESCC patients. Methods Recurrence ESC...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-08-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.70108 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846156214044459008 |
|---|---|
| author | Qing Liu Xue‐Hua Tu Rui‐Xuan Yu Hong‐Ying Wen Xiao‐Guang Guo Dai‐Yuan Ma Kai‐Yuan Jiang Dong Tian |
| author_facet | Qing Liu Xue‐Hua Tu Rui‐Xuan Yu Hong‐Ying Wen Xiao‐Guang Guo Dai‐Yuan Ma Kai‐Yuan Jiang Dong Tian |
| author_sort | Qing Liu |
| collection | DOAJ |
| description | Abstract Background The optimal treatment for esophageal squamous cell carcinoma (ESCC) patients with postoperative recurrence remains controversial. We aimed to evaluate the effects of radiotherapy (RT) and chemoradiotherapy (CRT) on postoperative recurrence in ESCC patients. Methods Recurrence ESCC patients who received salvage RT and CRT from January 2015 to January 2019 were retrospectively reviewed. Post‐recurrence survival (PRS) and prognostic factors were evaluated by Kaplan–Meier and Cox proportional hazards models, respectively. Subgroup analyses were performed based on pathological lymph node (LN) status (negative/positive) to evaluate the differences in salvage treatments and toxic reaction. Results A total of 170 patients were enrolled, with a median age of 60 years (range 43–77). No significant difference was found in the median PRS between the salvage RT and CRT groups (p > 0.05). Multivariate analysis revealed that TNM stage III and IV, macroscopic medullary type, and distant metastasis recurrence pattern were independent prognostic factors (all p < 0.05) for PRS. Salvage treatment was not associated with PRS (p = 0.897). However, in patients with negative LN, CRT was associated with prolonged survival (p = 0.043) and had no significant differences in toxic reactions compared to RT (p = 0.924). In addition, RT showed better prognoses (p = 0.020) and lower toxic reactions (p = 0.030) than CRT in patients with positive LNs. Conclusions Based on prognosis and toxic reactions, ESCC recurrence patients with negative LNs could benefit from CRT, but RT should be recommended for patients with positive LNs. |
| format | Article |
| id | doaj-art-fa2c07fb89834b3f8dfc21628b54c968 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-fa2c07fb89834b3f8dfc21628b54c9682024-11-26T10:12:30ZengWileyCancer Medicine2045-76342024-08-011316n/an/a10.1002/cam4.70108Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinomaQing Liu0Xue‐Hua Tu1Rui‐Xuan Yu2Hong‐Ying Wen3Xiao‐Guang Guo4Dai‐Yuan Ma5Kai‐Yuan Jiang6Dong Tian7Integrated Care Management Center West China Hospital, Sichuan University Chengdu ChinaAnesthesia Operation Center of West China Hospital/West China School of Nursing, Sichuan University Chengdu ChinaDepartment of Thoracic Oncology, Cancer Center West China Hospital, Sichuan University Chengdu ChinaDepartment of Cardiothoracic Intensive Care Unit Affiliated Hospital of North Sichuan Medical College Nanchong ChinaDepartment of Pathology Nanchong Central Hospital Nanchong ChinaDepartment of Oncology Affiliated Hospital of North Sichuan Medical College Nanchong ChinaDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaAbstract Background The optimal treatment for esophageal squamous cell carcinoma (ESCC) patients with postoperative recurrence remains controversial. We aimed to evaluate the effects of radiotherapy (RT) and chemoradiotherapy (CRT) on postoperative recurrence in ESCC patients. Methods Recurrence ESCC patients who received salvage RT and CRT from January 2015 to January 2019 were retrospectively reviewed. Post‐recurrence survival (PRS) and prognostic factors were evaluated by Kaplan–Meier and Cox proportional hazards models, respectively. Subgroup analyses were performed based on pathological lymph node (LN) status (negative/positive) to evaluate the differences in salvage treatments and toxic reaction. Results A total of 170 patients were enrolled, with a median age of 60 years (range 43–77). No significant difference was found in the median PRS between the salvage RT and CRT groups (p > 0.05). Multivariate analysis revealed that TNM stage III and IV, macroscopic medullary type, and distant metastasis recurrence pattern were independent prognostic factors (all p < 0.05) for PRS. Salvage treatment was not associated with PRS (p = 0.897). However, in patients with negative LN, CRT was associated with prolonged survival (p = 0.043) and had no significant differences in toxic reactions compared to RT (p = 0.924). In addition, RT showed better prognoses (p = 0.020) and lower toxic reactions (p = 0.030) than CRT in patients with positive LNs. Conclusions Based on prognosis and toxic reactions, ESCC recurrence patients with negative LNs could benefit from CRT, but RT should be recommended for patients with positive LNs.https://doi.org/10.1002/cam4.70108chemoradiotherapyesophageal squamous cell carcinomaprognosisradiotherapyrecurrencetoxicity |
| spellingShingle | Qing Liu Xue‐Hua Tu Rui‐Xuan Yu Hong‐Ying Wen Xiao‐Guang Guo Dai‐Yuan Ma Kai‐Yuan Jiang Dong Tian Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma Cancer Medicine chemoradiotherapy esophageal squamous cell carcinoma prognosis radiotherapy recurrence toxicity |
| title | Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma |
| title_full | Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma |
| title_fullStr | Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma |
| title_full_unstemmed | Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma |
| title_short | Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma |
| title_sort | radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma |
| topic | chemoradiotherapy esophageal squamous cell carcinoma prognosis radiotherapy recurrence toxicity |
| url | https://doi.org/10.1002/cam4.70108 |
| work_keys_str_mv | AT qingliu radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma AT xuehuatu radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma AT ruixuanyu radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma AT hongyingwen radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma AT xiaoguangguo radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma AT daiyuanma radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma AT kaiyuanjiang radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma AT dongtian radiotherapyandchemoradiotherapyforpostoperativerecurrenceinpatientswithesophagealsquamouscellcarcinoma |