T1bN0M0期食管癌患者内镜下黏膜下剥离术联合放化疗与单纯放疗的比较
Endoscopic Submucosal Dissection Followed by Chemoradiotherapy Versus Radiotherapy in Patients with Stage T1bN0M0 Esophageal Cancer.
作者信息
Lin Yan, Ma Cheng-Xian, Liang Huan-Wei, Huang Wei, Pan Xin-Bin
机构信息
Department of Gastroenterology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530000, People's Republic of China.
Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Qingxiu District, No. 71 Hedi Road, Nanning, Guangxi, 530021, People's Republic of China.
出版信息
J Gastrointest Cancer. 2025 Jul 11;56(1):150. doi: 10.1007/s12029-025-01270-4.
PURPOSE
To compare survival outcomes between endoscopic submucosal dissection (ESD) followed by chemoradiotherapy versus radiotherapy in stage T1bN0M0 esophageal cancer.
MATERIALS AND METHODS
Patients with stage T1bN0M0 esophageal cancer between 2000 and 2021 were identified from the Surveillance, Epidemiology, and End Results database. Cancer-specific survival (CSS) and overall survival (OS) were compared between the ESD followed by chemoradiotherapy versus radiotherapy cohorts.
RESULTS
Among 71 eligible patients, 57 (80.3%) received ESD followed by chemoradiotherapy and 14 (19.7%) underwent ESD followed by radiotherapy. Before propensity score matching, ESD followed by radiotherapy demonstrated inferior 5-year CSS (hazard ratio [HR] = 3.27, 95% confidence interval [CI] 1.12-9.58, P = 0.030), but comparable 5-year OS (HR = 1.46; 95% CI, 0.65-3.27; P = 0.362) versus ESD followed by chemoradiotherapy. After propensity score matching, no significant difference in 5-year CSS (HR = 1.76; 95% CI, 0.49-6.34; P = 0.386) or OS (HR = 1.33; 95% CI, 0.48-3.74; P = 0.585) was observed between treatment groups.
CONCLUSION
ESD followed by radiotherapy provides equivalent CSS and OS compared to ESD followed by chemoradiotherapy in patients with stage T1bN0M0 esophageal cancer.
目的
比较内镜黏膜下剥离术（ESD）联合放化疗与单纯放疗在T1bN0M0期食管癌中的生存结局。
材料与方法
从监测、流行病学和最终结果数据库中识别出2000年至2021年间的T1bN0M0期食管癌患者。比较ESD联合放化疗组与单纯放疗组的癌症特异性生存（CSS）和总生存（OS）情况。
结果
在71例符合条件的患者中，57例（80.3%）接受了ESD联合放化疗，14例（19.7%）接受了ESD联合放疗。在倾向评分匹配前，ESD联合放疗组的5年CSS较差（风险比[HR]=3.27，95%置信区间[CI]1.12 - 9.58，P=0.030），但5年OS与ESD联合放化疗组相当（HR=1.46；95%CI，0.65 - 3.27；P=0.362）。倾向评分匹配后，治疗组之间的5年CSS（HR=1.76；95%CI，0.49 - 6.34；P=0.386）或OS（HR=1.33；95%CI，0.48 - 3.74；P=0.585）均未观察到显著差异。
结论
在T1bN0M0期食管癌患者中，ESD联合放疗与ESD联合放化疗相比，提供了相当的CSS和OS。
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