采用标准或高放疗剂量的根治性同步放化疗治疗局限性食管鳞状细胞癌患者的疗效：一项针对危及器官剂量的回顾性研究
Outcomes of Localized Esophageal Squamous Cell Carcinoma Patients Treated With Definitive Concurrent Chemoradiotherapy Using Either Standard or High Radiotherapy Dose: A Retrospective Study Controlling for Organ at Risk Dose.
作者信息
Li Chia-Chin, Fang Hsin-Yuan, Lin Chen-Yuan, Shen Wei-Chih, Chien Chun-Ru
机构信息
Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C.
Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C.
出版信息
Anticancer Res. 2019 Jan;39(1):511-517. doi: 10.21873/anticanres.13142.
BACKGROUND/AIM: The optimal radiotherapy dose for localized esophageal squamous cell carcinoma (ESqCC) patients treated with definitive concurrent chemo-radiotherapy (CCRT) is debated. The aim of our study was to compare patient outcomes using either standard or high radiotherapy dose.
MATERIALS AND METHODS
Eligible patients diagnosed between 2011 and 2015 from the cancer registry of our Institute were identified and a propensity score (PS)-matched cohort (1:1 for high vs. standard dose) was constructed to balance observable potential confounders (including organ at risk dose). The hazard ratio (HR) of death between high and standard dose was compared.
RESULTS
Our study population included 73/36 patients before/after PS matching. The HR of death at the high dose compared to the standard dose was 0.554 (95% confidence interval (CI)=0.308-0.998, p=0.049).
CONCLUSION
Definitive CCRT using a high radiotherapy dose showed improved survival outcomes for localized ESqCC patients compared to standard dose.
背景/目的：对于接受根治性同步放化疗（CCRT）的局限性食管鳞状细胞癌（ESqCC）患者，最佳放疗剂量存在争议。我们研究的目的是比较使用标准放疗剂量或高放疗剂量时患者的预后。
材料与方法
从我们研究所的癌症登记处确定2011年至2015年间诊断的符合条件的患者，并构建倾向评分（PS）匹配队列（高剂量与标准剂量为1:1）以平衡可观察到的潜在混杂因素（包括危及器官剂量）。比较高剂量和标准剂量之间的死亡风险比（HR）。
结果
我们的研究人群在PS匹配前/后分别包括73/36例患者。与标准剂量相比，高剂量时的死亡HR为0.554（95%置信区间（CI）=0.308 - 0.998，p = 0.049）。
结论
与标准剂量相比，对于局限性ESqCC患者，使用高放疗剂量的根治性CCRT显示出更好的生存预后。
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