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. 2022 Aug 10;22(1):381.
doi: 10.1186/s12876-022-02464-x.

Consolidative chemotherapy after definitive concurrent chemoradiotherapy for esophageal squamous cell carcinoma patients: a population based cohort study

Chen-Yuan Lin #  1   2 , Ming-Yu Lien #  1   3 , Chi-Ching Chen #  1 , Hsin-Yuan Fang #  4   3 , Yu-Sen Lin  4 , Chien-Kuang Chen  4 , Jian-Xun Chen  4 , Ting-Yu Lu  4 , Tzu-Min Huang  4 , Te-Chun Hsieh  5   6 , Shung-Shung Sun  5   6 , Chia-Chin Li  7 , Chun-Ru Chien  8   9
Affiliations

Consolidative chemotherapy after definitive concurrent chemoradiotherapy for esophageal squamous cell carcinoma patients: a population based cohort study

Chen-Yuan Lin et al. BMC Gastroenterol. .

Abstract

Background: The role of consolidative chemotherapy (CCT) for locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients treated with definitive concurrent chemoradiotherapy (dCCRT) is unclear. We aimed to compare the overall survival (OS) of those treated with vs without CCT via a population based approach.

Methods: Eligible LA-ESCC patients diagnosed between 2011 and 2017 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratio (HR) of death and incidence of esophageal cancer mortality (IECM) were compared between those with vs without CCT. We also evaluated the OS in supplementary analyses via alternative approaches.

Results: Our primary analysis consisted of 368 patients in whom covariates were well balanced after PS weighting. The HR of death when CCT was compared to without was 0.67 (95% confidence interval 0.52-0.86, P = 0.002). The HR of IECM was 0.66 (P = 0.04). The HR of OS remained similarly in favor of CCT in supplementary analyses.

Conclusions: We found that CCT was associated with significantly improved OS for LA-ESCC patients treated with dCCRT. Randomized controlled trials were needed to confirm this finding.

Keywords: Consolidative chemotherapy; Definitive concurrent chemoradiotherapy; Esophageal squamous cell carcinoma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
STROBE study flowchart and the number of individuals at each stage of the study. 1We only included those treated (class 1–2) to ensure data consistency. 2Clinical stage cT2-4N0M0 or cT1-4N+M0 for the 7th American Joint Committee on Cancer staging. 350–70 Gy in 1.8–2 Gy/fraction. 4Without missing information in the TCR and death registry regarding survival status, and cause of death
Fig. 2
Fig. 2
Kaplan–Meier unadjusted overall survival curve (in years) in the primary analysis. CCT, consolidative chemotherapy
Fig. 3
Fig. 3
The overlap weights adjusted overall survival curve (in years) in the primary analysis. CCT, consolidative chemotherapy
Fig. 4
Fig. 4
Kaplan–Meier survival curve (in years) for the PS-matched subgroup (SA-1). CCT, consolidative chemotherapy
See this image and copyright information in PMC

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