Outcomes of concurrent chemoradiotherapy versus chemotherapy alone for stage IV esophageal squamous cell carcinoma: a retrospective controlled study

Abstract

BackgroundThe purpose of this study is to compare the efficacy and safety of concurrent chemoradiotherapy (CCRT) versus chemotherapy alone for patients with stage IV esophageal squamous cell carcinoma (ESCC).MethodsEligible patients were retrospectively enrolled at the authors’s institution from January 2010 to October 2015. Of the 141 patients enrolled, 55 (39.0%) received CCRT and 86 (61.0%) received chemotherapy alone. The outcomes and adverse events (AEs) were compared between the two groups.ResultsThe baseline clinical characteristics of the two groups were similar. However, the CCRT group showed a significantly better primary tumor objective response rate (ORR) than that of the chemotherapy group (74.5% versus 45.3%, p = 0.001). The 1-year, 2-year, 3-year overall survival (OS) rates and median OS were 58.0% versus 43.0%, 25.5% versus 14.0%, 10.7% versus 4.7%, and 14 months versus 11 months for patients treated with CCRT or chemotherapy, respectively (p = 0.007). The 1-year and median progression-free survival (PFS) were 29.8% versus 14.9% and 8 months versus 6 months (p = 0.005). Multivariate analysis identified CCRT (p = 0.013) and solitary metastasis (p = 0.037) as independent factors for greater OS. The frequency of leucocytopenia (grade 3 or higher) was significantly higher in the CCRT group than in the chemotherapy-alone group (p = 0.040), whereas the rates of other AEs did not differ.ConclusionsIn this study, it is suggested that CCRT is more effective than chemotherapy alone for stage IV ESCC, yielding better primary responses and survival outcomes with tolerable side effects.

Overexpression of the Long Noncoding RNA FOXD2-AS1 Promotes Cisplatin Resistance in Esophageal Squamous Cell Carcinoma Through the miR-195/Akt/mTOR Axis

“…Cisplatin (CDDP) is a platinum agent commonly applied for ESCC, and its application, with and without other agents, has led to a noticeable improvement in prognosis 5 . Nevertheless, acquired resistance to chemotherapy is a frequent cause of treatment failure 6,7 . Consequently, avoiding resistance is crucial for prognosis 8,9 .…”

Local Ablative Treatment Improves Survival in ESCC Patients With Specific Metastases, 2010–2016: A Population-Based SEER Analysis

“…Another retrospective study of 198 stage IV ESCC patients reported that the CRT group had a longer median OS (14.0 months vs. 11.0 months, p = 0.007) than the chemotherapy group (74.5% versus 45.3%, p = 0.001). Multivariate analysis identified CRT (CRT vs. chemotherapy: HR = 0.626, 95% CI: 0.437–0.898, p = 0.013) and solitary metastasis (solitary vs. multiple metastasis: HR = 0.621, 95% CI: 0.426–0.905, p = 0.037) as independent factors for better OS in this study ( 24 ). The number of metastases may also be a prognostic factor, but it was not provided from the SEER database in our study.…”

The association between mortality and use of Chinese herbal medicine among incident stage IV esophageal cancer patients: A retrospective cohort study with core herbs exploration

“…A Korean multi-institutional cohort study showed similar data that with multiple treatment modalities, the 5-year OS rate was about 16.6%, and mOS was 0.9 years ( Jung et al, 2020 ). In China, a retrospective controlled study reported that the 3-year OS rate of advanced-stage EC patients was about 4.7%–10.7%, and the mOS was about 11–14 months ( Lyu et al, 2018 ). In our study, even though the 5-year OS seemed similar among all eligible subjects, the higher OS rate among CHM users revealed the possibility of integrating CHM with palliative management.…”