Department of Medical Oncology, Kushiro Rosai Hospital, 13-23 Nakazono-cho, Kushiro, Hokkaido, 085-8533, Japan.
Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Int J Clin Oncol. 2022 Aug;27(8):1279-1288. doi: 10.1007/s10147-022-02185-x. Epub 2022 Jul 2.
Recently, the JCOG0502 has shown a comparable efficacy of chemoradiotherapy and esophagectomy in patients with clinical T1N0M0 esophageal squamous cell carcinoma. However, few studies have compared the clinical outcomes of these treatments in esophageal squamous cell carcinoma patients (including elderly patients) based on real-world data.
This retrospective study determined real-world outcomes in patients who underwent chemoradiotherapy or esophagectomy, including those with clinical T1N0M0 esophageal squamous cell carcinoma, between 2009 and 2017 at the National Cancer Center Hospital East.
Among a total of 156 patients, 120 and 36 patients underwent esophagectomy and chemoradiotherapy, respectively; 138, 12 and 6 patients had Eastern Cooperative Oncology Group performance status 0, 1, and 2, respectively; and 33 and 123 patients had clinical tumor depth MM-SM1 and SM2-SM3, respectively. In a median follow-up of 72 months, 5-year progression-free survival and overall survival were respectively 77.0% and 81.5% in the esophagectomy group and 74.4% and 82.6% in the chemoradiotherapy group (P = 0.48 and, P = 0.89). Moreover, no treatment-related death was detected in both groups. In elderly patients (75 years or older), 5-year progression-free survival and overall survival were not significantly different between esophagectomy and chemoradiotherapy groups (5-year progression-free survival: 72.3% vs. 81.8%, P = 0.38; 5-year overall survival: 76.9% vs. 81.8%, P = 0.59).
This real-world study confirms the results of a previous clinical trial, and the present findings support chemoradiotherapy as one of the standard treatment options in patients of all ages with clinical T1N0M0 esophageal squamous cell carcinoma.
最近，JCOG0502 研究表明，对于临床 T1N0M0 期食管鳞癌患者，放化疗与手术治疗的疗效相当。然而，基于真实世界数据，比较这些治疗方法在食管鳞癌患者（包括老年患者）中的临床结局的研究较少。
本回顾性研究分析了 2009 年至 2017 年在日本国立癌症中心东医院接受放化疗或手术治疗的临床 T1N0M0 期食管鳞癌患者的真实世界结局，包括这些患者。
共纳入 156 例患者，120 例行手术治疗，36 例行放化疗；Eastern Cooperative Oncology Group 体力状态分别为 0、1、2 的患者分别为 138、12、6 例；临床肿瘤深度分别为 MM-SM1 和 SM2-SM3 的患者分别为 33、123 例。中位随访 72 个月后，手术组和放化疗组的 5 年无进展生存率和总生存率分别为 77.0%和 81.5%（P=0.48 和 P=0.89）。两组均未发生与治疗相关的死亡。在老年患者（75 岁及以上）中，手术组和放化疗组的 5 年无进展生存率和总生存率无显著差异（5 年无进展生存率：72.3%比 81.8%，P=0.38；5 年总生存率：76.9%比 81.8%，P=0.59）。
本真实世界研究证实了先前临床试验的结果，本研究结果支持放化疗作为所有年龄段临床 T1N0M0 期食管鳞癌患者的标准治疗选择之一。
