KEY TAKEAWAYS
- The study aimed to compare the effects of RT and CRT on postoperative recurrence in patients with ESCC.
- Researchers found that CRT benefits ESCC with negative lymph nodes, while RT is better for those with positive nodes.
The optimal treatment for patients with esophageal squamous cell carcinoma (ESCC) with postoperative recurrence remains controversial.
Qing Liu and the team aimed to evaluate the effects of radiotherapy (RT) and chemoradiotherapy (CRT) on postoperative recurrence in patients with ESCC.
They performed an inclusive analysis of recurrence patients with ESCC who received salvage RT and CRT between January 2015 and January 2019. Post-recurrence survival (PRS) and prognostic factors were assessed using Kaplan-Meier and Cox proportional hazards models.
The analysis also included subgroup evaluations based on pathological lymph node (LN) status (negative/positive) to investigate differences in salvage treatments and toxic reactions.
About 170 patients were enrolled, with a median age of 60 years (range 43-77). No significant difference was found in the median PRS between the salvage RT and CRT groups (P > 0.05). Multivariate analysis revealed that TNM stage III and IV, macroscopic medullary type, and distant metastasis recurrence pattern were independent prognostic factors (all P < 0.05) for PRS. Salvage treatment was not associated with PRS (P = 0.897).
However, in patients with negative lymph nodes (LN), CRT was associated with prolonged survival (P = 0.043) and had no significant differences in toxic reactions compared to RT (P = 0.924). In addition, RT showed better prognoses (P = 0.020) and lower toxic reactions (P = 0.030) than CRT in patients with positive LNs.
The study concluded that, based on prognosis and toxic reactions, ESCC recurrence patients with negative LNs could benefit from CRT, while RT should be recommended for patients with positive LNs.
This study was funded by the 2023 Clinical Research Fund, West China Hospital, Sichuan University (Dong Tian, No. 2023HXFH042); Youth Innovation Scientific Research Project of Sichuan Medical Association (Hong-Ying Wen, No. Q21040); Preliminary Research Program of National Natural Science Foundation, North Sichuan Medical College (Hong-Ying Wen, No. 20SXZRKX0001).
Source: https://pubmed.ncbi.nlm.nih.gov/39161098/
Liu Q, Tu XH, Yu RX, et al. (2024). “Radiotherapy and chemoradiotherapy for postoperative recurrence in patients with esophageal squamous cell carcinoma.” Cancer Med. 2024 Aug;13(16):e70108. doi: 10.1002/cam4.70108. PMID: 39161098.
