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Delayed postoperative radiotherapy might improve the long-term prognosis of locally advanced esophageal squamous cell carcinoma.
Lin, Ming-Qiang; Li, Jin-Luan; Zhang, Zong-Kai; Chen, Xiao-Hui; Ma, Jia-Yu; Dai, Ya-Qing; Huang, Shu-Yun; Hu, Yi-Bin; Li, Jian-Cheng.
Afiliação
  • Lin MQ; Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, Fujian 350014, China. Electronic address: mingqianglin1995@126.com.
  • Li JL; Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, Fujian 350014, China. Electronic address: lijinluan@pku.org.cn.
  • Zhang ZK; Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen 361003, China. Electronic address: zzk8089@hotmail.com.
  • Chen XH; Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, Fujian 350014, China. Electronic address: chenxiaojun13@hotmail.com.
  • Ma JY; Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, Fujian 350014, China. Electronic address: majiayu0802@163.com.
  • Dai YQ; Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen 361003, China. Electronic address: yaqingdai@126.com.
  • Huang SY; Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, Fujian 350014, China. Electronic address: 956600391@qq.com.
  • Hu YB; Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, Fujian 350014, China. Electronic address: 461171244@qq.com.
  • Li JC; Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, 420 Fuma Rd, Jin'an District, Fuzhou, Fujian 350014, China. Electronic address: jianchengli_jack@126.com.
Transl Oncol ; 14(1): 100956, 2021 Jan.
Article em En | MEDLINE | ID: mdl-33227662
ABSTRACT

OBJECTIVE:

There is no consensus on the optimal timing of postoperative radiotherapy (PORT) for locally advanced esophageal squamous cell carcinoma (ESCC). We aimed to determine whether the timing of PORT affects the long-term prognosis of ESCC, and plotted nomograms to predict survival.

METHODS:

We retrospectively analyzed 351 ESCC patients who underwent radical surgery and PORT. Receiver operating characteristic curves were used to estimate the optimal cutoff point of the time interval between surgery and PORT. Cox proportional hazards regression was used to identify prognostic predictors. Overall survival (OS) and progression-free survival (PFS) were predicted using nomograms.

RESULTS:

The median follow-up was 53 months (range 3-179 months). Compared to early PORT, PORT at >48 days after surgery was associated with better OS (adjusted hazard ratio [HR] 1.406, p = 0.037) and PFS (adjusted HR 1.475, p = 0.018). In the chemotherapy subgroup, incorporation of chemotherapy timing into the analysis suggested that 2-4 chemotherapy cycles followed by PORT was the optimal treatment schedule as compared to 0-1 chemotherapy cycle followed by PORT and concurrent chemoradiotherapy (5-year PFS 65.9% vs. 51.0% vs. 50.1%; p = 0.049). The nomograms for OS and PFS were superior to the TNM classification (concordance indices 0.721 vs. 0.626 and 0.716 vs. 0.610, respectively).

CONCLUSIONS:

Delayed PORT (>48 days) provides better survival benefit than early PORT among ESCC patients. PORT following 2-4 chemotherapy cycles might lead to the best survival rate. The nomogram plotted in this study effectively predicted survival and may help guide treatment.
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Texto completo: 1 Bases de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Transl Oncol Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Transl Oncol Ano de publicação: 2021 Tipo de documento: Article