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Maintenance chemotherapy for esophageal squamous cell carcinoma after standard concurrent chemoradiotherapy: a national propensity score matching cohort study.

作者信息

Tseng Szu-Wen, Chen Wan-Ming, Jao An-Tzu, Chen Mingchih, Shia Ben-Chang, Wu Szu-Yuan

机构信息

Division of Medical Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital Yilan, Taiwan.

Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University Taipei, Taiwan.

出版信息

Am J Cancer Res. 2024 May 15;14(5):2300-2312. doi: 10.62347/BCKH8310. eCollection 2024.


DOI:10.62347/BCKH8310
PMID:38859861
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11162678/
Abstract

Esophageal squamous cell carcinoma (ESCC) is a common and aggressive cancer, and its standard treatment is concurrent chemoradiotherapy (CCRT). Maintenance chemotherapy is often used to help prevent cancer recurrence, but its efficacy for patients with ESCC receiving CCRT remains unclear. We conducted a large head-to-head propensity score matching cohort study to estimate the effects of maintenance chemotherapy on overall survival and cancer-specific survival in patients with ESCC receiving standard CCRT. After propensity score matching (PSM), we recruited 2724 patients with ESCC (2177 in the maintenance chemotherapy group and 547 in the non-maintenance chemotherapy group). The adjusted hazard ratios (95% confidence intervals) of all-cause mortality and cancer-specific mortality for the maintenance chemotherapy group were 1.15 (1.06-1.26, = 0.0014) and 1.08 (0.88-1.29, = 0.1320), respectively, compared with the non-maintenance chemotherapy group. We also found that older age, relatively lower body mass index (BMI), higher American Joint Committee on Cancer clinical stage, and poor response to CCRT as measured using the Response Evaluation Criteria in Solid Tumors were poor independent predictors of all-cause mortality and cancer-specific mortality. Our findings indicated that maintenance chemotherapy may not improve the survival of patients with ESCC who have received CCRT. Additionally, we identified several key prognostic factors for patients with ESCC receiving CCRT, including relatively low BMI and poor response to CCRT. Further research is needed to understand the benefits and risks of maintenance chemotherapy in similar patient populations in order to identify new therapies that could improve treatment responses.

摘要

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本文引用的文献

[1]
Use of Preoperative FDG PET/CT and Survival of Patients with Resectable Non-Small Cell Lung Cancer.

Radiology. 2022-10

[2]
Omitting surgery in esophageal cancer patients with complete response after neoadjuvant chemoradiotherapy: a systematic review and meta-analysis.

Radiat Oncol. 2021-11-14

[3]
Oral maintenance therapy using apatinib combined with S-1/capecitabine for esophageal squamous cell carcinoma with residual disease after definitive chemoradiotherapy.

Aging (Albany NY). 2021-3-10

[4]
Neoadjuvant Chemotherapy or Endocrine Therapy for Invasive Ductal Carcinoma of the Breast With High Hormone Receptor Positivity and Human Epidermal Growth Factor Receptor 2 Negativity.

JAMA Netw Open. 2021-3-1

[5]
Long-Term Survival in Nonsurgical Esophageal Cancer Patients Who Received Consolidation Chemotherapy Compared With Patients Who Received Concurrent Chemoradiotherapy Alone: A Systematic Review and Meta-Analysis.

Front Oncol. 2021-1-7

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Surg Oncol. 2021-3

[7]
Pathologic response as predictor of recurrence, metastasis, and survival in breast cancer patients receiving neoadjuvant chemotherapy and total mastectomy.

Am J Cancer Res. 2020-10-1

[8]
Definitive radiotherapy or surgery for early oral squamous cell carcinoma in old and very old patients: A propensity-score-matched, nationwide, population-based cohort study.

Radiother Oncol. 2020-10

[9]
Survival Comparision of Three-dimensional Radiotherapy Alone vs. Chemoradiotherapy for Esophageal Squamous Cell Carcinoma.

Arch Med Res. 2020-5-14

[10]
Randomized Phase III Study of Continuation Maintenance Bevacizumab With or Without Pemetrexed in Advanced Nonsquamous Non-Small-Cell Lung Cancer: COMPASS (WJOG5610L).

J Clin Oncol. 2019-12-27

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