Mian Xi1, Zhongxing Liao2, Weiye Deng3, Cai Xu4, Ritsuko Komaki2, Mariela Blum5, Wayne L Hofstetter6, Linus Ho5, Steven H Lin7. 1. Department of Radiation Oncology, Cancer Center, Sun Yat-Sen University, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China. 2. Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. 3. Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston, Texas. 4. Department of Radiation Oncology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. 5. Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. 6. Cardiovascular and Thoracic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. 7. Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. Electronic address: shlin@mdanderson.org.
Abstract
OBJECTIVES: The aim of this study was to identify patients with esophageal cancer who may benefit from induction chemotherapy (IC) before neoadjuvant chemoradiotherapy (nCRT) on the basis of a prognostic scoring model. METHODS: Between 1998 and 2015, 535 patients with esophageal cancer who underwent nCRT were included for analysis, including 218 patients who received IC before nCRT (IC group) and 317 patients who did not receive IC (non-IC group). A prognostic scoring model was developed to predict disease-free survival (DFS) on the basis of a Cox proportional hazards model. RESULTS: The median follow-up time was 63.5 months (range 8.0-178.5) for survivors. The 5-year DFS rates were similar between the IC and non-IC groups (53.7% vs. 45.1%, p = 0.196). Multivariate analysis determined that histologic grade, tumor location, baseline positron emission tomography maximum standard uptake value, and lymph node size were independent prognostic factors for DFS. A prognostic scoring system was constructed by using these four factors, with the total score ranging from 0 to 6.2. When the median value was used as a cutoff, low-risk (≤3.5) and high-risk (>3.5) groups were identified. In the high-risk group, patients who received IC had a nonsignificantly higher pathologic complete response rate (p = 0.272) and a significantly better DFS (p = 0.03) than patients who did not receive IC. After propensity score matching, the high-risk group demonstrated a significantly improved DFS with IC, a benefit that was not observed in the low-risk group. CONCLUSIONS: On the basis of the prognostic scoring model, the addition of IC to nCRT may provide a DFS benefit in high-risk patients with a risk score higher than 3.5. Prospective validation is warranted.
OBJECTIVES: The aim of this study was to identify patients with esophageal cancer who may benefit from induction chemotherapy (IC) before neoadjuvant chemoradiotherapy (nCRT) on the basis of a prognostic scoring model. METHODS: Between 1998 and 2015, 535 patients with esophageal cancer who underwent nCRT were included for analysis, including 218 patients who received IC before nCRT (IC group) and 317 patients who did not receive IC (non-IC group). A prognostic scoring model was developed to predict disease-free survival (DFS) on the basis of a Cox proportional hazards model. RESULTS: The median follow-up time was 63.5 months (range 8.0-178.5) for survivors. The 5-year DFS rates were similar between the IC and non-IC groups (53.7% vs. 45.1%, p = 0.196). Multivariate analysis determined that histologic grade, tumor location, baseline positron emission tomography maximum standard uptake value, and lymph node size were independent prognostic factors for DFS. A prognostic scoring system was constructed by using these four factors, with the total score ranging from 0 to 6.2. When the median value was used as a cutoff, low-risk (≤3.5) and high-risk (>3.5) groups were identified. In the high-risk group, patients who received IC had a nonsignificantly higher pathologic complete response rate (p = 0.272) and a significantly better DFS (p = 0.03) than patients who did not receive IC. After propensity score matching, the high-risk group demonstrated a significantly improved DFS with IC, a benefit that was not observed in the low-risk group. CONCLUSIONS: On the basis of the prognostic scoring model, the addition of IC to nCRT may provide a DFS benefit in high-risk patients with a risk score higher than 3.5. Prospective validation is warranted.
Authors: Charlène J van der Zijden; Ben M Eyck; Ate van der Gaast; Leni van Doorn; Joost J M E Nuyttens; J Jan B van Lanschot; Bas P L Wijnhoven; Bianca Mostert; Sjoerd M Lagarde Journal: Contemp Clin Trials Commun Date: 2022-05-28
Authors: Lucas Goense; Peter S N van Rossum; Mian Xi; Dipen M Maru; Brett W Carter; Gert J Meijer; Linus Ho; Richard van Hillegersberg; Wayne L Hofstetter; Steven H Lin Journal: Ann Surg Oncol Date: 2018-03-22 Impact factor: 5.344
Authors: Lucas Goense; Jelle P Ruurda; Brett W Carter; Penny Fang; Linus Ho; Gert J Meijer; Richard van Hillegersberg; Wayne L Hofstetter; Steven H Lin Journal: Eur J Nucl Med Mol Imaging Date: 2018-04-16 Impact factor: 9.236