PDF(Pubmed)
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, P = 0.0014) and 1.08 (0.88-1.29, P = 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：
食管鳞状细胞癌（ESCC）是一种常见的侵袭性癌症，其标准治疗是同步放化疗（CCRT）。维持化疗通常用于帮助预防癌症复发，但其对接受CCRT的ESCC患者的疗效尚不清楚.我们进行了一项大型头对头倾向评分匹配队列研究，以评估维持化疗对接受标准CCRT的ESCC患者的总体生存率和癌症特异性生存率的影响。在倾向得分匹配(PSM)之后，我们招募了2724例ESCC患者(维持化疗组2177例,非维持化疗组547例).维持化疗组的全因死亡率和癌症特异性死亡率的校正风险比(95%置信区间)分别为1.15(1.06-1.26,P=0.0014)和1.08(0.88-1.29,P=0.1320),分别,与非维持化疗组比较。我们还发现年龄较大，相对较低的体重指数（BMI），高等美国癌症临床阶段联合委员会，使用实体肿瘤疗效评价标准测量的CCRT疗效差,是全因死亡率和癌症特异性死亡率的独立预测因子.我们的发现表明，维持化疗可能不会改善接受CCRT的ESCC患者的生存率。此外,我们确定了接受CCRT的ESCC患者的几个关键预后因素，包括相对较低的BMI和对CCRT的反应差。需要进一步的研究来了解类似患者人群中维持化疗的益处和风险，以确定可以改善治疗反应的新疗法。
