Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis

Autor: Xueqing Zhang, Liang Hong, Xiaoyi Lin, Yunxia Huang, Qingyang Zhuang, Bu-hong Zheng, Lirui Tang, Kaixin Du, Shao-li Cai, Jinluan Li, Junxin Wu
Rok vydání: 2018
Předmět:
lcsh:Medical physics. Medical radiology. Nuclear medicine
Adult
Male
medicine.medical_specialty
Esophageal Neoplasms
medicine.medical_treatment
lcsh:R895-920
Gastroenterology
lcsh:RC254-282
Re-Irradiation
03 medical and health sciences
0302 clinical medicine
Esophageal squamous cell carcinoma
Internal medicine
Positron Emission Tomography Computed Tomography
medicine
Humans
Radiology
Nuclear Medicine and imaging
Overall survival
Propensity Score
Locoregional recurrence
Lymph node
Aged
Retrospective Studies
Aged
80 and over
business.industry
Proportional hazards model
Incidence (epidemiology)
Research
Hazard ratio
Esophageal cancer
Middle Aged
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Radiation therapy
medicine.anatomical_structure
Oncology
Propensity score-matched analysis
030220 oncology & carcinogenesis
Concomitant
Propensity score matching
Carcinoma
Squamous Cell
030211 gastroenterology & hepatology
Female
Neoplasm Recurrence
Local
business
Zdroj: Radiation Oncology (London, England)
Radiation Oncology, Vol 13, Iss 1, Pp 1-9 (2018)
ISSN: 1748-717X
Popis: Background To investigate the treatment failure pattern and factors influencing locoregional recurrence of esophageal squamous cell carcinoma (ESCC) and examine patient survival with re-irradiation (re-RT) after primary radiotherapy. Methods We retrospectively analyzed 87 ESCC patients treated initially with radiotherapy. Failure patterns were classified into regional lymph node recurrence only (LN) and primary failure with/without regional lymph node recurrence (PF). Patients received either re-RT or other treatments (non-re-RT group). Baseline covariates were balanced by a propensity score model. Overall survival (OS) and toxicities were assessed as outcomes. Results The median follow-up time was 87 months. Thirty-nine patients received re-RT. Failure pattern and re-RT were independent prognostic factors for OS (P = 0.040 and 0.015) by Cox multivariate analysis. Re-RT with concomitant chemotherapy showed no survival benefit over re-RT alone (P = 0.70). No differences in characteristics were found between the groups by Chi-square tests after propensity score matching. The Cox model showed that failure pattern and re-RT were prognostic factors with hazard ratios (HR) of 0.319 (P = 0.025) and 0.375 (P = 0.002), respectively, in the matched cohort. Significant differences in OS were observed according to failure pattern (P = 0.004) and re-RT (P 0.05). The incidence of radiation pneumonitis was higher in the re-RT group (24.24% vs. 6.06%, P = 0.039), but no cases of pneumonia-related death occurred. Conclusions Re-RT improved long-term survival in patients with locoregional recurrent ESCC. Despite a high incidence of radiation pneumonitis, toxicities were tolerable.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje