- Book学术

发布求助

文献互助智能选刊最新文献

IF 9.1 1区医学 Q1 ONCOLOGY

Cancer letters Pub Date : 2024-12-28 DOI:10.1016/j.canlet.2024.217411

Jiacheng Li, Xiaofeng Wang, Jianzhong Cao, Chengcheng Fan, Qin Xiao, Zhunhao Zheng, Wenyan Gao, Xiao Liu, Peixin Feng, Fang Liu, Shuyu Ouyang, Tian Zhang, Xi Chen, Zhiyong Yuan, Qingsong Pang, Ping Wang, Qifeng Wang, Wencheng Zhang

{"title":"Immunochemotherapy plus radiotherapy versus immunochemotherapy alone as first-line treatment for treatment-naïve, advanced esophageal squamous cell carcinoma (AEC-ICR-1st): A multi-center cohort study.","authors":"Jiacheng Li, Xiaofeng Wang, Jianzhong Cao, Chengcheng Fan, Qin Xiao, Zhunhao Zheng, Wenyan Gao, Xiao Liu, Peixin Feng, Fang Liu, Shuyu Ouyang, Tian Zhang, Xi Chen, Zhiyong Yuan, Qingsong Pang, Ping Wang, Qifeng Wang, Wencheng Zhang","doi":"10.1016/j.canlet.2024.217411","DOIUrl":null,"url":null,"abstract":"<p><p>Immunochemotherapy is Currently the standard first-line treatment for advanced esophageal squamous cell carcinoma (ESCC). However, its prognosis remains unsatisfactory. We aimed to evaluate the efficacy and safety of immunochemotherapy plus radiotherapy (ICR) compared with immunochemotherapy (IC) alone as a first-line treatment for advanced ESCC. This multicenter cohort study was conducted across five cancer centers (NCT06190652). We evaluated the outcomes in patients with advanced ESCC who received first-line therapy of IC, with or without radiotherapy (RT), between 2018 and 2023. Propensity score matching (PSM) was performed to control for potential confounders. Sensitivity analysis was conducted to evaluate the robustness of the results. Overall, 23,641 patients were screened, and 702 patients were finally eligible. 270 patients included in ICR cohort, and 432 patients in IC alone cohort. Both before and after PSM, the ICR cohort had a longer median OS compared to IC alone cohort (20.4 versus 16.8 months, P = 0.001; 21.3 versus 17.5 months, P = 0.008; respectively); multivariate analysis further supported that RT was associated with a better OS (HR: 0.695, 95%CI: 0.558-0.867, P = 0.001; HR: 0.729, 95%CI: 0.561-0.947, P = 0.018; respectively). Exploratory analysis revealed that the survival benefits were most pronounced in the subgroup that received IC concurrently combined with definitive dose RT to the primary tumor, with a median OS of 23.6 months (HR: 0.515, 95%CI: 0.308-0.862, P = 0.011) and PFS of 14.4 months (HR: 0.567, 95%CI: 0.370-0.870, P = 0.009). The grade ≥3 treatment-related adverse events (TRAEs) were esophagitis (4.10 % versus 0.41 %; P = 0.006), anemia (6.97 % versus 1.64 %; P = 0.004), leukopenia (12.70 % versus 6.56 %; P = 0.021) and lymphopenia (38.52 % versus 4.92 %, P < 0.001) in the ICR and IC cohorts. The addition of RT to IC as a first-line treatment for advanced ESCC could bring benefits, and was well-tolerated.</p>","PeriodicalId":9506,"journal":{"name":"Cancer letters","volume":" ","pages":"217411"},"PeriodicalIF":9.1000,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer letters","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.canlet.2024.217411","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目前，免疫化疗是晚期食管鳞状细胞癌（ESCC）的标准一线治疗方法。然而，其预后仍不令人满意。我们旨在评估免疫化疗加放疗（ICR）与单纯免疫化疗（IC）作为晚期食管鳞癌一线治疗方法的有效性和安全性。这项多中心队列研究在五个癌症中心进行（NCT06190652）。我们评估了2018年至2023年期间接受IC一线治疗（无论是否接受放疗（RT））的晚期ESCC患者的预后。为了控制潜在的混杂因素，我们进行了倾向评分匹配（PSM）。进行了敏感性分析以评估结果的稳健性。共筛选出 23641 名患者，最终有 702 名患者符合条件。其中 270 名患者被纳入 ICR 组群，432 名患者被纳入单纯 IC 组群。在 PSM 之前和之后，ICR 队列的中位 OS 均长于单纯 IC 队列（分别为 20.4 个月对 16.8 个月，P =0.001；21.3 个月对 17.5 个月，P =0.008；分别）；多变量分析进一步支持 RT 与更好的 OS 相关（HR：0.695，95%CI：0.558-0.867，P =0.001；HR：0.729，95%CI：0.561-0.947，P =0.018；分别）。探索性分析显示，在接受IC治疗的亚组中，原发肿瘤同时接受确定剂量RT治疗的生存获益最为明显，中位OS为23.6个月（HR：0.515，95%CI：0.308-0.862，P=0.011），PFS为14.4个月（HR：0.567，95%CI：0.370-0.870，P=0.009）。在ICR和IC队列中，≥3级治疗相关不良事件（TRAEs）为食管炎（4.10%对0.41%；P =0.006）、贫血（6.97%对1.64%；P =0.004）、白细胞减少（12.70%对6.56%；P =0.021）和淋巴细胞减少（38.52%对4.92%，P <0.001）。作为晚期ESCC的一线治疗，在IC基础上加用RT可带来益处，且耐受性良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Immunochemotherapy plus radiotherapy versus immunochemotherapy alone as first-line treatment for treatment-naïve, advanced esophageal squamous cell carcinoma (AEC-ICR-1st): A multi-center cohort study.

Immunochemotherapy is Currently the standard first-line treatment for advanced esophageal squamous cell carcinoma (ESCC). However, its prognosis remains unsatisfactory. We aimed to evaluate the efficacy and safety of immunochemotherapy plus radiotherapy (ICR) compared with immunochemotherapy (IC) alone as a first-line treatment for advanced ESCC. This multicenter cohort study was conducted across five cancer centers (NCT06190652). We evaluated the outcomes in patients with advanced ESCC who received first-line therapy of IC, with or without radiotherapy (RT), between 2018 and 2023. Propensity score matching (PSM) was performed to control for potential confounders. Sensitivity analysis was conducted to evaluate the robustness of the results. Overall, 23,641 patients were screened, and 702 patients were finally eligible. 270 patients included in ICR cohort, and 432 patients in IC alone cohort. Both before and after PSM, the ICR cohort had a longer median OS compared to IC alone cohort (20.4 versus 16.8 months, P = 0.001; 21.3 versus 17.5 months, P = 0.008; respectively); multivariate analysis further supported that RT was associated with a better OS (HR: 0.695, 95%CI: 0.558-0.867, P = 0.001; HR: 0.729, 95%CI: 0.561-0.947, P = 0.018; respectively). Exploratory analysis revealed that the survival benefits were most pronounced in the subgroup that received IC concurrently combined with definitive dose RT to the primary tumor, with a median OS of 23.6 months (HR: 0.515, 95%CI: 0.308-0.862, P = 0.011) and PFS of 14.4 months (HR: 0.567, 95%CI: 0.370-0.870, P = 0.009). The grade ≥3 treatment-related adverse events (TRAEs) were esophagitis (4.10 % versus 0.41 %; P = 0.006), anemia (6.97 % versus 1.64 %; P = 0.004), leukopenia (12.70 % versus 6.56 %; P = 0.021) and lymphopenia (38.52 % versus 4.92 %, P < 0.001) in the ICR and IC cohorts. The addition of RT to IC as a first-line treatment for advanced ESCC could bring benefits, and was well-tolerated.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Cancer letters 医学-肿瘤学

CiteScore

17.70

自引率

2.10%

发文量

427

审稿时长

15 days

期刊介绍： Cancer Letters is a reputable international journal that serves as a platform for significant and original contributions in cancer research. The journal welcomes both full-length articles and Mini Reviews in the wide-ranging field of basic and translational oncology. Furthermore, it frequently presents Special Issues that shed light on current and topical areas in cancer research. Cancer Letters is highly interested in various fundamental aspects that can cater to a diverse readership. These areas include the molecular genetics and cell biology of cancer, radiation biology, molecular pathology, hormones and cancer, viral oncology, metastasis, and chemoprevention. The journal actively focuses on experimental therapeutics, particularly the advancement of targeted therapies for personalized cancer medicine, such as metronomic chemotherapy. By publishing groundbreaking research and promoting advancements in cancer treatments, Cancer Letters aims to actively contribute to the fight against cancer and the improvement of patient outcomes.