Delayed postoperative radiotherapy might improve the long-term prognosis of locally advanced esophageal squamous cell carcinoma.
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, pâ¯=â¯0.037) and PFS (adjusted HR 1.475, pâ¯=â¯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%; pâ¯=â¯0.049). The nomograms for OS and PFS were superior to the TNM classification (concordance indices 0.721â¯vs. 0.626 and 0.716â¯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.
Texto completo:
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Bases de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
Idioma:
En
Revista:
Transl Oncol
Ano de publicação:
2021
Tipo de documento:
Article