Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 Gy

ABSTRACT Background The efficacy of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CCRT) has not been clearly defined in esophageal squamous cell carcinoma (ESCC). This study determined which patients with stage II‐IVA ESCC benefitted from CCT. Methods 351 patients with ESC...

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Main Authors: Hualei Zhang, Qi Wang, Ping Wang, Bo Tang
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Thoracic Cancer
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Online Access:https://doi.org/10.1111/1759-7714.70012
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author Hualei Zhang
Qi Wang
Ping Wang
Bo Tang
author_facet Hualei Zhang
Qi Wang
Ping Wang
Bo Tang
author_sort Hualei Zhang
collection DOAJ
description ABSTRACT Background The efficacy of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CCRT) has not been clearly defined in esophageal squamous cell carcinoma (ESCC). This study determined which patients with stage II‐IVA ESCC benefitted from CCT. Methods 351 patients with ESCC were retrospectively reviewed. 185 patients received CCRT alone and 166 received CCRT plus CCT. Subset analyses were conducted on all patients' characteristics. Factors associated with survival were analyzed using the Kaplan–Meier method and a Cox proportional hazards model. The Propensity score matching (PSM) technique was used to compensate for differences in patients' characteristics. Results The median OS were 17.7 months and 38.4 months in the CCRT alone group and CCRT+CCT group (p = 0.002), respectively. Multivariable Cox regression analysis determined that CCT was associated with improved OS (p = 0.002, HR 0.592, 95% CI 0.423–0.829); After PSM, relative to the CCRT group, patients who received CCT experienced improved OS (17.7 months vs. 38.4 months, p = 0.0139). Subgroup analysis showed that CCT was more effective in radiation dose < 60 Gy (p = 0.002, HR 0.368, 95% CI 0.194–0.700). After matching between radiation dose, in the low dose cohort, the median OS was 13.2 months and 20.7 months in the CCRT alone group and CCRT+CCT group, respectively (p = 0.0028), the multivariate analysis results showed that CCT retained its statistical significance (p = 0.002, HR 0.353, 95% CI 0.183–0.681). In the high dose cohort, the median OS were 21.6 months and 23.6 months in the CCRT alone group and CCRT+CCT group, respectively (p = 0.5512). Conclusions We recommend that CCT treatment should be considered for ESCC patients who underwent CCRT using < 60 Gy. Further studies are needed to confirm these results.
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spelling doaj-art-8f615121860c414b8bc83d2160ca16862025-08-20T02:12:25ZengWileyThoracic Cancer1759-77061759-77142025-04-01167n/an/a10.1111/1759-7714.70012Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 GyHualei Zhang0Qi Wang1Ping Wang2Bo Tang3Department of Radiation Oncology The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital Zhengzhou ChinaDepartment of Radiation Oncology The Fourth Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Radiation Oncology Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer Tianjin ChinaDepartment of Radiation Oncology The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital Zhengzhou ChinaABSTRACT Background The efficacy of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CCRT) has not been clearly defined in esophageal squamous cell carcinoma (ESCC). This study determined which patients with stage II‐IVA ESCC benefitted from CCT. Methods 351 patients with ESCC were retrospectively reviewed. 185 patients received CCRT alone and 166 received CCRT plus CCT. Subset analyses were conducted on all patients' characteristics. Factors associated with survival were analyzed using the Kaplan–Meier method and a Cox proportional hazards model. The Propensity score matching (PSM) technique was used to compensate for differences in patients' characteristics. Results The median OS were 17.7 months and 38.4 months in the CCRT alone group and CCRT+CCT group (p = 0.002), respectively. Multivariable Cox regression analysis determined that CCT was associated with improved OS (p = 0.002, HR 0.592, 95% CI 0.423–0.829); After PSM, relative to the CCRT group, patients who received CCT experienced improved OS (17.7 months vs. 38.4 months, p = 0.0139). Subgroup analysis showed that CCT was more effective in radiation dose < 60 Gy (p = 0.002, HR 0.368, 95% CI 0.194–0.700). After matching between radiation dose, in the low dose cohort, the median OS was 13.2 months and 20.7 months in the CCRT alone group and CCRT+CCT group, respectively (p = 0.0028), the multivariate analysis results showed that CCT retained its statistical significance (p = 0.002, HR 0.353, 95% CI 0.183–0.681). In the high dose cohort, the median OS were 21.6 months and 23.6 months in the CCRT alone group and CCRT+CCT group, respectively (p = 0.5512). Conclusions We recommend that CCT treatment should be considered for ESCC patients who underwent CCRT using < 60 Gy. Further studies are needed to confirm these results.https://doi.org/10.1111/1759-7714.70012chemoradiotherapyconsolidation chemotherapyESCC
spellingShingle Hualei Zhang
Qi Wang
Ping Wang
Bo Tang
Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 Gy
Thoracic Cancer
chemoradiotherapy
consolidation chemotherapy
ESCC
title Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 Gy
title_full Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 Gy
title_fullStr Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 Gy
title_full_unstemmed Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 Gy
title_short Consolidation Chemotherapy Provided Survival Benefit for Esophageal Squamous Cell Carcinoma Patients Who Underwent Concurrent Chemoradiotherapy Lower Than 60 Gy
title_sort consolidation chemotherapy provided survival benefit for esophageal squamous cell carcinoma patients who underwent concurrent chemoradiotherapy lower than 60 gy
topic chemoradiotherapy
consolidation chemotherapy
ESCC
url https://doi.org/10.1111/1759-7714.70012
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