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Chemoradiotherapy Versus Radiotherapy in Patients With Stage T1N0M0 Esophageal Cancer: A Retrospective Cohort Study
Run-Zhi Wang1, Huan-Wei Liang1, Yang Liu1
1Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
Background And Aim:
The aim of this study is to compare the survival outcomes between radiotherapy and chemoradiotherapy in patients with stage T1N0M0 esophageal cancer.
Methods:
Stage T1N0M0 esophageal cancer patients treated with either radiotherapy or chemoradiotherapy were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020. Cancer-specific survival (CSS) and overall survival (OS) were compared between the radiotherapy and chemoradiotherapy groups.
Results:
A total of 41 patients (22.9%) underwent radiotherapy, while 138 patients (77.1%) received chemoradiotherapy. For stage T1a cases, chemoradiotherapy exhibited a similar 5-year CSS (35.9% vs. 26.1%; hazard ratio [HR] = 0.84, 95% confidence interval [CI]: 0.49-1.42; p = 0.511) and OS (24.1% vs. 10.0%; HR = 0.77, 95% CI: 0.50-1.20; p = 0.249) compared to radiotherapy. For stage T1b cases, chemoradiotherapy exhibited a similar 5-year CSS (33.4% vs. 18.2%; HR = 1.05, 95% CI: 0.41-2.70; p = 0.919) and OS (23.4% vs. 9.1%; HR = 0.68, 95% CI: 0.34-1.36; p = 0.272) compared to radiotherapy. Multivariable proportional hazards regression analysis confirmed that chemoradiotherapy was not an independent prognostic factor for CSS (HR = 0.89, 95% CI: 0.29-2.74; p = 0.833). However, chemoradiotherapy was an independent prognostic factor for OS (HR = 0.42, 95% CI: 0.19-0.94; p = 0.034).
Conclusion:
Radiotherapy is comparable to chemoradiotherapy in stage T1a cases. However, chemoradiotherapy is superior to radiotherapy in stage T1b patients.
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