Department of Radiotherapy, Bengang General Hospital of Health Industry Group, Benxi 117000, China.
J Immunol Res. 2022 Oct 15;2022:7581799. doi: 10.1155/2022/7581799. eCollection 2022.
To explore the impact of radiation dose on preoperative neoadjuvant chemoradiotherapy effects for patients with locally advanced squamous cell esophageal carcinoma (LASCEC) with long-term follow-up data.
The patients with LASCEC received either low dose radiotherapy (50.4Gy/23f/1.8Gy) or a high dose (64.8Gy/25f/1.8Gy) followed by neoadjuvant chemotherapy preoperatively were included in this study. To balance potential bias, 1 : 1 propensity score matching (PSM) with a caliper of 0.1 was used. The two groups were compared in terms of radical resection, post-radiation adverse event rates, perioperative mortality, postoperative adverse event rates, overall survival (OS), local recurrence rate, and distant metastatic rate.
Forty-two patients were enrolled in this study, with 21 patients in each group after PSM. There was no difference in baseline characteristics between the two groups (all p >0.05). The rates of radical resection (71.4% vs 57.1%, P =0.334), perioperative mortality (9.5% vs 4.8%, P =0.549), and postoperative adverse event rates (76.2% vs 90.5%, P =0.410) did not differ significantly between the two groups. The 5-year OS rate was statistically higher in the group with a high dose (66.7% vs. 28.6%, P =0.013). Meanwhile, the local recurrence rate was statistically lower in the high dose group (14.3% vs 47.6%, P =0.019 for 3 years; 33.3% vs 66.6%, P =0.031 for 5 years). Moreover, the 3-year distant metastasis rate was statistically lower in the group with a high dose (9.5% vs 38.1%, P = 0.03).
Patients with LASCEC may benefit from preoperative neoadjuvant chemoradiotherapy with a high radiation dosage (64.8Gy/25f/1.8Gy).
探讨具有长期随访数据的局部晚期食管鳞状细胞癌（LASCEC）患者接受术前新辅助放化疗时，辐射剂量对其疗效的影响。
本研究纳入的 LASCEC 患者接受低剂量放疗（50.4Gy/23f/1.8Gy）或高剂量放疗（64.8Gy/25f/1.8Gy）联合术前新辅助化疗。为了平衡潜在的偏倚，采用了 0.1 卡尺的 1:1 倾向评分匹配（PSM）。比较两组患者的根治性切除率、放疗后不良反应发生率、围手术期死亡率、术后不良反应发生率、总生存率（OS）、局部复发率和远处转移率。
本研究共纳入 42 例患者，PSM 后每组各 21 例。两组患者的基线特征无差异（均 P>0.05）。两组根治性切除率（71.4% vs 57.1%，P=0.334）、围手术期死亡率（9.5% vs 4.8%，P=0.549）和术后不良反应发生率（76.2% vs 90.5%，P=0.410）差异均无统计学意义。高剂量组 5 年 OS 率显著较高（66.7% vs. 28.6%，P=0.013）。同时，高剂量组局部复发率显著较低（3 年时为 14.3% vs 47.6%，P=0.019；5 年时为 33.3% vs 66.6%，P=0.031）。此外，高剂量组 3 年远处转移率显著较低（9.5% vs 38.1%，P=0.03）。
LASCEC 患者接受术前新辅助放化疗时，高剂量（64.8Gy/25f/1.8Gy）可能获益。
