Tags

Type your tag names separated by a space and hit enter

Effectiveness of image-guided radiotherapy for locally advanced esophageal squamous cell carcinoma patients treated with definitive concurrent chemoradiotherapy.

Abstract

BACKGROUND

Image-guided radiotherapy (IGRT) is an advanced radiotherapy technique to improve the accuracy of treatment delivery. However, a recent randomized controlled trial (RCT) for prostate cancer patients treated with radiotherapy either via IGRT or routine care (no daily IGRT) reported a statistically significant worse overall survival for those treated with IGRT. This raised the concern regarding the effectiveness of IGRT for definitive concurrent chemoradiotherapy (dCCRT) for locally advanced esophageal squamous cell carcinoma (LA-ESqCC).

METHODS

Eligible LA-ESqCC patients diagnosed between 2011 and 2015 were identified via the Taiwan Cancer Registry. We estimated propensity scores to construct a 1:1 propensity-score-matched groups and balance observable potential confounders. The hazard ratio (HR) of death as well as other outcomes was compared between IGRT and non-IGRT matched groups during the entire follow-up period. The impact of additional covariables was considered in the sensitivity analysis.

RESULTS

Our study population included 590 patients in the primary analysis. The HR for death when IGRT was compared with non-IGRT was 0.92 (95% confidence interval 0.77-1.10, P = 0.35). There were also no significant differences for other outcomes or sensitivity analyses.

CONCLUSIONS

In this updated nonrandomized study using real world data, we found that the overall survival of LA-ESqCC patients treated with dCCRT was not statistically different between those treated with IGRT versus those without IGRT, although the hazard ratio was less than unity, ie, in favor of IGRT. The results should be interpreted with caution given the nonrandomized design and RCTs are needed to clarify our findings.

Authors+Show Affiliations

Department of Radiation Oncology, E-Da Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan.Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan.Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan. Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31742897

Citation

Kuo, Yao-Hung, et al. "Effectiveness of Image-guided Radiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma Patients Treated With Definitive Concurrent Chemoradiotherapy." Thoracic Cancer, 2019.
Kuo YH, Fang HY, Lin YS, et al. Effectiveness of image-guided radiotherapy for locally advanced esophageal squamous cell carcinoma patients treated with definitive concurrent chemoradiotherapy. Thorac Cancer. 2019.
Kuo, Y. H., Fang, H. Y., Lin, Y. S., Lein, M. Y., Yang, C. Y., Ho, S. C., ... Chien, C. R. (2019). Effectiveness of image-guided radiotherapy for locally advanced esophageal squamous cell carcinoma patients treated with definitive concurrent chemoradiotherapy. Thoracic Cancer, doi:10.1111/1759-7714.13244.
Kuo YH, et al. Effectiveness of Image-guided Radiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma Patients Treated With Definitive Concurrent Chemoradiotherapy. Thorac Cancer. 2019 Nov 19; PubMed PMID: 31742897.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of image-guided radiotherapy for locally advanced esophageal squamous cell carcinoma patients treated with definitive concurrent chemoradiotherapy. AU - Kuo,Yao-Hung, AU - Fang,Hsin-Yuan, AU - Lin,Yu-Sen, AU - Lein,Ming-Yu, AU - Yang,Chi-Ying, AU - Ho,Shih-Chi, AU - Li,Chia-Chin, AU - Chien,Chun-Ru, Y1 - 2019/11/19/ PY - 2019/09/27/received PY - 2019/10/24/revised PY - 2019/10/25/accepted PY - 2019/11/20/entrez KW - Concurrent chemoradiotherapy KW - esophageal squamous cell carcinoma KW - image-guided radiotherapy JF - Thoracic cancer JO - Thorac Cancer N2 - BACKGROUND: Image-guided radiotherapy (IGRT) is an advanced radiotherapy technique to improve the accuracy of treatment delivery. However, a recent randomized controlled trial (RCT) for prostate cancer patients treated with radiotherapy either via IGRT or routine care (no daily IGRT) reported a statistically significant worse overall survival for those treated with IGRT. This raised the concern regarding the effectiveness of IGRT for definitive concurrent chemoradiotherapy (dCCRT) for locally advanced esophageal squamous cell carcinoma (LA-ESqCC). METHODS: Eligible LA-ESqCC patients diagnosed between 2011 and 2015 were identified via the Taiwan Cancer Registry. We estimated propensity scores to construct a 1:1 propensity-score-matched groups and balance observable potential confounders. The hazard ratio (HR) of death as well as other outcomes was compared between IGRT and non-IGRT matched groups during the entire follow-up period. The impact of additional covariables was considered in the sensitivity analysis. RESULTS: Our study population included 590 patients in the primary analysis. The HR for death when IGRT was compared with non-IGRT was 0.92 (95% confidence interval 0.77-1.10, P = 0.35). There were also no significant differences for other outcomes or sensitivity analyses. CONCLUSIONS: In this updated nonrandomized study using real world data, we found that the overall survival of LA-ESqCC patients treated with dCCRT was not statistically different between those treated with IGRT versus those without IGRT, although the hazard ratio was less than unity, ie, in favor of IGRT. The results should be interpreted with caution given the nonrandomized design and RCTs are needed to clarify our findings. SN - 1759-7714 UR - https://www.unboundmedicine.com/medline/citation/31742897/Effectiveness_of_image-guided_radiotherapy_for_locally_advanced_esophageal_squamous_cell_carcinoma_patients_treated_with_definitive_concurrent_chemoradiotherapy L2 - https://doi.org/10.1111/1759-7714.13244 DB - PRIME DP - Unbound Medicine ER -