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Does chemoradiotherapy benefit elderly patients with esophageal squamous cell cancer? A propensity-score matched analysis on multicenter data (3JECROG R-03A)

Authors
  • Chen, Mingqiu1
  • Liu, Xiaohong2
  • Han, Chun3
  • Wang, Xin4
  • Zhao, Yidian5
  • Pang, Qingsong6
  • Sun, Xinchen7
  • Li, Gaofeng8
  • Zhang, Kaixian9
  • Li, Ling9
  • Qiao, Xueying3
  • Lin, Yu1
  • Chen, Junqiang1
  • Xiao, Zefen4
  • 1 Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No. 420, Fumalu Road, Jinan District, Fuzhou City, Fujian Province, People’s Republic of China , Fuzhou City (China)
  • 2 Fujian Medical University, Fuzhou, Fujian, 350122, China , Fuzhou (China)
  • 3 the Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China , Shijiazhuang (China)
  • 4 Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China , Beijing (China)
  • 5 Anyang Cancer Hospital, Anyang, 455000, China , Anyang (China)
  • 6 Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin, 300060, China , Tianjin (China)
  • 7 the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China , Nanjing (China)
  • 8 Beijing Hospital, National Center of Gerontology, Beijing, 100730, China , Beijing (China)
  • 9 Tengzhou Central People’s Hospital, Tengzhou, 277599, China , Tengzhou (China)
Type
Published Article
Journal
BMC Cancer
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jan 15, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12885-019-6461-z
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe aim of the present study was to assess the efficacy of concurrent chemoradiotherapy (CRT) or radiotherapy alone (RT-alone) in elderly patients with esophageal squamous cell carcinoma (ESCC).MethodsThe clinical data of patients with ESCC treated with RT-alone or CRT were collected and retrospectively reviewed. The 1-, 3- and 5-year overall survival (OS) rates and the clinical characteristics correlated with survival were analyzed statistically. Propensity score matching (PSM) analyses were used to compensate for differences in baseline characteristics between the CRT and RT-alone groups to confirm the survival difference.ResultsA total of 729 patients fulfilling the inclusion criteria were reviewed. Diabetes, primary tumor volume (pTV), primary tumor location (pTLo), clinical T stage,(cT) clinical N stage (cN), clinical M stage (cM) and short-term response to RT were independent factors influencing OS (P = 0.002–0.044). The 5-year OS rate was 26.6, 26.0 and 30.1% in the whole cohort, RT-alone and CRT groups, respectively. The survival difference between RT alone and CRT was not significant before or following PSM. Compared with the corresponding subgroups treated with RT alone, CRT significantly benefited patients with diabetes (P = 0.003), cT4 (P = 0.030) and cN0 (P = 0.049), whereas no benefit was identified between CRT and RT alone in the other subgroups, including cT1–3, cN1, cM, pTLo, pTV, age and gender.ConclusionsCRT with the current chemotherapy regimens may not improve the survival of elderly ESCC patients compared to RT-alone, except in patients with cT4 stage, cN0 stage or diabetes. However, due to the limitation of the retrospective nature of the current study, further clinical trials are required for confirmation.

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