术后放化疗对淋巴结阳性食管鳞癌的生存获益。
Survival benefits of postoperative chemoradiation for lymph node-positive esophageal squamous cell carcinoma.
机构信息
Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
出版信息
Ann Thorac Surg. 2014 May;97(5):1734-41. doi: 10.1016/j.athoracsur.2013.12.041. Epub 2014 Mar 6.
BACKGROUND
Little is known about the efficacy of chemoradiation therapy after surgery for patients with esophageal squamous cell carcinoma. This retrospective study aimed to determine whether postoperative chemoradiation improves survival compared with surgery alone.
METHODS
Of 290 patients with esophageal squamous cell carcinoma, 104 received postoperative chemoradiation therapy (CRT group) and 186 underwent surgery alone (S group). Propensity score matching analysis was used to identify 56 well-balanced pairs of patients to compare outcomes.
RESULTS
For N0 patients, overall survival (OS) and disease-free survival (DFS) were similar in both groups. For N+ patients, the median OS (31.0 versus 16.0 months) and the 3-year OS rate (45.8% versus 14.1%) were significantly higher in the CRT group than in the S group (p<0.001). Similarly, the median DFS (16.0 versus 9.0 months) and the 3-year DFS rate (24.1% versus 11.5%) were significantly higher in the CRT group than in the S group (p=0.002). In propensity-matched patients, a survival benefit was observed for N+ patients receiving postoperative chemoradiation (CRT versus S group: median OS 29.0 versus 16.0 months, 3-year OS rate 48.6% versus 16.8%; p=0.003). Disease-free survival (median DFS 11.0 versus 8.0 months, 3-year DFS rate 21.3% versus 12.5%) tended to be better in the CRT group than in the S group (p=0.057).
CONCLUSIONS
Postoperative chemoradiation therapy provided a survival benefit for patients with lymph node-positive esophageal squamous cell carcinoma.
背景
对于接受食管鳞癌手术的患者，术后放化疗的疗效知之甚少。本回顾性研究旨在确定与单纯手术相比，术后放化疗是否能提高生存率。
方法
在 290 例食管鳞癌患者中，104 例接受术后放化疗（CRT 组），186 例仅接受手术（S 组）。采用倾向评分匹配分析，比较两组患者的生存结局。
结果
对于 N0 患者，两组的总生存（OS）和无病生存（DFS）无显著差异。对于 N+ 患者，CRT 组的中位 OS（31.0 个月对 16.0 个月）和 3 年 OS 率（45.8%对 14.1%）显著高于 S 组（p<0.001）。同样，CRT 组的中位 DFS（16.0 个月对 9.0 个月）和 3 年 DFS 率（24.1%对 11.5%）也显著高于 S 组（p=0.002）。在倾向评分匹配患者中，N+ 患者接受术后放化疗具有生存获益（CRT 组与 S 组：中位 OS 29.0 个月对 16.0 个月，3 年 OS 率 48.6%对 16.8%；p=0.003）。DFS 也有改善趋势（CRT 组与 S 组：中位 DFS 11.0 个月对 8.0 个月，3 年 DFS 率 21.3%对 12.5%；p=0.057）。
结论
术后放化疗为淋巴结阳性食管鳞癌患者提供了生存获益。
Zotero 插件