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Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study

BACKGROUND: The optimal radiation dose for treating non-metastatic superficial esophageal squamous cell carcinoma is unknown. In this retrospective observational study, we investigated the influence of radiation dose and pretreatment endoscopic prediction of tumor invasion depth on local recurrence...

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Autores principales: Ikawa, Toshiki, Ishihara, Ryu, Matsueda, Katsunori, Konishi, Koji, Yamamoto, Sachiko, Morimoto, Masahiro, Kanayama, Naoyuki, Teshima, Teruki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939113/
https://www.ncbi.nlm.nih.gov/pubmed/35313853
http://dx.doi.org/10.1186/s12885-022-09418-2
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author Ikawa, Toshiki
Ishihara, Ryu
Matsueda, Katsunori
Konishi, Koji
Yamamoto, Sachiko
Morimoto, Masahiro
Kanayama, Naoyuki
Teshima, Teruki
author_facet Ikawa, Toshiki
Ishihara, Ryu
Matsueda, Katsunori
Konishi, Koji
Yamamoto, Sachiko
Morimoto, Masahiro
Kanayama, Naoyuki
Teshima, Teruki
author_sort Ikawa, Toshiki
collection PubMed
description BACKGROUND: The optimal radiation dose for treating non-metastatic superficial esophageal squamous cell carcinoma is unknown. In this retrospective observational study, we investigated the influence of radiation dose and pretreatment endoscopic prediction of tumor invasion depth on local recurrence after definitive chemoradiotherapy in patients with superficial esophageal squamous cell carcinoma. METHODS: We analyzed 134 patients with clinical Tis–T1N0M0 esophageal squamous cell carcinoma who underwent chemoradiotherapy at our institution between 2006 and 2019. Patients were grouped into standard-dose (50.0–50.4 Gy) and high-dose (60.0 Gy) radiotherapy groups. The outcomes of interest were local recurrence and major local recurrence (endoscopically unresectable local recurrent tumors). Kaplan–Meier analysis and the log-rank test were used with propensity score and inverse probability of treatment weighting. Cox proportional hazards analysis was performed to identify predictors of local recurrence and major local recurrence. RESULTS: The median follow-up times were 52 and 84 months for the standard-dose and high-dose groups, respectively. The adjusted 3-year local recurrence and major local recurrence rates in the standard-dose and high-dose groups were 33.8 and 9.6% (adjusted hazard ratio, 4.00 [95% confidence interval: 1.64–9.73]; adjusted log-rank p = 0.001) and 12.5 and 4.7% (adjusted hazard ratio, 3.13 [95% confidence interval: 0.91–10.81]; adjusted log-rank p = 0.098), respectively. Cox proportional hazards analysis showed that standard-dose radiotherapy and endoscopic findings of deep submucosal invasion are independently associated with local recurrence and major local recurrence. CONCLUSIONS: High-dose radiotherapy is more beneficial for local tumor control than standard-dose radiotherapy in patients with non-metastatic superficial esophageal squamous cell carcinoma. The use of high-dose radiotherapy may merit consideration for tumors with deep submucosal invasion. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-022-09418-2.
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spelling pubmed-89391132022-03-23 Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study Ikawa, Toshiki Ishihara, Ryu Matsueda, Katsunori Konishi, Koji Yamamoto, Sachiko Morimoto, Masahiro Kanayama, Naoyuki Teshima, Teruki BMC Cancer Research BACKGROUND: The optimal radiation dose for treating non-metastatic superficial esophageal squamous cell carcinoma is unknown. In this retrospective observational study, we investigated the influence of radiation dose and pretreatment endoscopic prediction of tumor invasion depth on local recurrence after definitive chemoradiotherapy in patients with superficial esophageal squamous cell carcinoma. METHODS: We analyzed 134 patients with clinical Tis–T1N0M0 esophageal squamous cell carcinoma who underwent chemoradiotherapy at our institution between 2006 and 2019. Patients were grouped into standard-dose (50.0–50.4 Gy) and high-dose (60.0 Gy) radiotherapy groups. The outcomes of interest were local recurrence and major local recurrence (endoscopically unresectable local recurrent tumors). Kaplan–Meier analysis and the log-rank test were used with propensity score and inverse probability of treatment weighting. Cox proportional hazards analysis was performed to identify predictors of local recurrence and major local recurrence. RESULTS: The median follow-up times were 52 and 84 months for the standard-dose and high-dose groups, respectively. The adjusted 3-year local recurrence and major local recurrence rates in the standard-dose and high-dose groups were 33.8 and 9.6% (adjusted hazard ratio, 4.00 [95% confidence interval: 1.64–9.73]; adjusted log-rank p = 0.001) and 12.5 and 4.7% (adjusted hazard ratio, 3.13 [95% confidence interval: 0.91–10.81]; adjusted log-rank p = 0.098), respectively. Cox proportional hazards analysis showed that standard-dose radiotherapy and endoscopic findings of deep submucosal invasion are independently associated with local recurrence and major local recurrence. CONCLUSIONS: High-dose radiotherapy is more beneficial for local tumor control than standard-dose radiotherapy in patients with non-metastatic superficial esophageal squamous cell carcinoma. The use of high-dose radiotherapy may merit consideration for tumors with deep submucosal invasion. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-022-09418-2. BioMed Central 2022-03-21 /pmc/articles/PMC8939113/ /pubmed/35313853 http://dx.doi.org/10.1186/s12885-022-09418-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Ikawa, Toshiki
Ishihara, Ryu
Matsueda, Katsunori
Konishi, Koji
Yamamoto, Sachiko
Morimoto, Masahiro
Kanayama, Naoyuki
Teshima, Teruki
Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study
title Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study
title_full Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study
title_fullStr Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study
title_full_unstemmed Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study
title_short Influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–I esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study
title_sort influence of radiation dose and predicted tumor invasion depth on local recurrence after definitive chemoradiotherapy for stage 0–i esophageal squamous cell carcinoma: a propensity score-weighted, retrospective, observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939113/
https://www.ncbi.nlm.nih.gov/pubmed/35313853
http://dx.doi.org/10.1186/s12885-022-09418-2
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