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Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:

2024 23

Page:

4449-4458

Research Field:

Publishing date:

Info

Title:

Survival analysis of different neoadjuvant treatment modes in locally advanced esophageal squamous cell carcinoma based on the stabilized inverse probability of treatment weighting method

Author(s):

LI Jiao¹; YU Nuo¹; FENG Guojie¹; ZHENG Ziyu¹; LIANG Jun²; DENG Lei¹; ZHANG Tao¹; WANG Wenqing¹; LIU Wenyang¹; WANG Jianyang¹; FENG Qinfu¹; LYU Jima¹; ZHOU Zongmei¹; XIAO Zefen¹; BI Nan¹; WANG Zhen³; CHEN Xiankai³; KANG Xiaozheng³; ZHANG Ruixiang³; ZHENG Qingfeng³; QIN Jianjun³; LI Yong³; LI Yin³; WANG Xin¹

Keywords:

-

PACS:

R735.1

DOI:

10.3969/j.issn.1672-4992.2024.23.005

Abstract:

Objective:To compare the effects of neoadjuvant radiotherapy(nCRT) and neoadjuvant chemotherapy(nCT) on overall survival(OS) and disease-free survival(DFS) in patients with locally advanced esophageal squamous carcinoma.Methods:A total of 416 patients with esophageal squamous cell carcinoma who underwent neoadjuvant therapy in our hospital from 2012 to 2020,including 258 patients in the nCT group and 158 patients in the nCRT group.The covariates were weighted in the nCRT and nCT groups using a stabilized inverse probability treatment weighting method(sIPTW) to corrected for confounders.The OS and DFS were calculated by K-M method,compared by logrank test,and multivariate analysis were performed by Cox regression model.Results:The median follow-up time was 56(7~145) months in the nCRT and 51(6~118)months in the nCT group.69 of the 416 patients(16.6%) achieved pCR in the whole group,with a significantly higher pCR rate(28.5% vs 9.3%,P＜0.001) in the nCRT group than in the nCT group.Median survival was not reached in the nCRT and nCT groups.Before sIPTW,there was no significant difference in overall survival（P＝0.770） and disease-free survival（P＝0.845） between the two groups.After sIPTW,nCRT promoted slightly more favorable survival,despite without statistical significance in overall survival(the 3-and 5-years overall survival rates of the nCRT and nCT groups were 80.1% vs 77.0% and 72.1% vs 66.3%,P＝0.281) and disease-free survival(the 3-and 5-years were 70.2% vs 64.5% and 61.0% vs 55.2%，P＝0.315),respectively.pT(P＝0.005) and pN(P＝0.007) were independent factors affecting the prognosis of esophageal cancer.Patients who receive pCR had significantly higher OS （P＜0.001）and DFS（P＜0.001） compared to non-pCR patients.Conclusion:nCRT received higher pCR rate significantly compared with nCT,and patients who achieve pCR rate have an excellent survival prognosis.After sIPTW,a trend favored nCRT related to the significantly higher OS and DFS in the nCRT group was better than that in the nCT group,but no significant differences was reached.In the future,prospective clinical trials to compare these two modes of neoadjuvant therapies in ESCC are warranted.

References:

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Memo

Memo:

北京市希思科临床肿瘤学研究基金（编号：Y-Young2023-0114）

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Last Update: 2024-11-01