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Comparative Outcomes of Induction Chemotherapy Followed By Definitive Chemoradiotherapy versus Chemoradiotherapy Alone In Esophageal Squamous Cell Carcinoma

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机构: [1]Guangdong Esophageal Canc Inst, State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [2]Collaborat Innovat Ctr Canc Med, Guangzhou, Guangdong, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Dept Radiat Oncol, 651 Dongfeng East Rd, Guangzhou 510060, Guangdong, Peoples R China; [4]Sun Yat Sen Univ, Canc Ctr, Imaging Diag & Intervent Ctr, Guangzhou, Guangdong, Peoples R China
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关键词: Esophageal squamous cell carcinoma induction chemotherapy definitive chemoradiotherapy survival toxicity

摘要:
Purpose: To compare the clinical outcomes of induction chemotherapy (IC) followed by chemoradiotherapy (CRT) versus chemoradiotherapy alone in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Patients and methods: Between 2002 and 2015, 267 ESCC patients who received definitive CRT with docetaxel and cisplatin were enrolled in this study. Through a matched case-control study, 85 patients receiving IC before CRT were matched 1: 1 to patients who received CRT alone, according to age, gender, performance status, tumor location, tumor length, and pretreatment TNM stage. Results: The median overall survival (OS) in the IC group was significantly better than that in the CRT group (26.0 vs. 22.0 months), with 3-year OS rates of 30.6% vs. 25.9%, respectively (P = 0.028). However, IC plus CRT was associated with a significantly higher rate of grade 3-4 leukopenia than CRT alone (P = 0.048). The overall clinical response rate was 50.6% after IC in the IC group. The IC responder group showed significantly more favorable OS (P= 0.002) and progression-free survival (P= 0.001) compared with the IC non-responder group and the CRT group. Multivariate analysis revealed that age = 60 (P = 0.003) and the addition of IC (P= 0.016) were independent prognostic factors that affected survival positively. Conclusions: The addition of IC before CRT yielded satisfactory clinical outcomes and manageable toxicities. The combination of IC with CRT might be a promising treatment strategy to further improve systemic control and survival in ESCC. Prospective randomized trials are required to confirm the role of IC.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
第一作者:
第一作者机构: [1]Guangdong Esophageal Canc Inst, State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [2]Collaborat Innovat Ctr Canc Med, Guangzhou, Guangdong, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Dept Radiat Oncol, 651 Dongfeng East Rd, Guangzhou 510060, Guangdong, Peoples R China;
通讯作者:
通讯机构: [1]Guangdong Esophageal Canc Inst, State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [2]Collaborat Innovat Ctr Canc Med, Guangzhou, Guangdong, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Dept Radiat Oncol, 651 Dongfeng East Rd, Guangzhou 510060, Guangdong, Peoples R China;
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