Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

References

    1. Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390(10110):2383–2396. doi: 10.1016/S0140-6736(17)31462-9. - DOI - PubMed
    1. Chien CR, Lin CY, Chen CY. Re: incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst. 2009;101(20):1428; author reply 1429. - PubMed
    1. Lordick F, Mariette C, Haustermans K, Obermannová R, Arnold D; ESMO Guidelines Committee. Oesophageal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27(suppl 5):v50–7. - PubMed
    1. Kitagawa Y, Uno T, Oyama T, Kato K, Kato H, Kawakubo H, et al. Esophageal cancer practice guidelines 2017 edited by the Japan esophageal society: part 2. Esophagus. 2019;16(1):25–43. doi: 10.1007/s10388-018-0642-8. - DOI - PMC - PubMed
    1. Shah MA, Kennedy EB, Catenacci DV, Deighton DC, Goodman KA, Malhotra NK, et al. Treatment of locally advanced esophageal carcinoma: ASCO guideline. J Clin Oncol. 2020;38(23):2677–2694. doi: 10.1200/JCO.20.00866. - DOI - PubMed

MeSH terms