Evaluation Of The Efficacy Of Adjuvant Chemotherapy After Definitive Chemoradiotherapy For Esophageal Cancer

ObjectiveTo evaluate the efficacy of adjuvant chemotherapy(AC)in patients with esophageal squamous cell carcinoma(ESCC)undergoing definitive chemoradiotherapy(CRT).Patients and MethodsThe clinical data of patients with esophageal squamous cell carcinoma who treated with definitive chemoradiotherapy with or without adjuvant chemotherapy at two hospitals from September 1,2004 to December 31,2015 were collected.Kaplan-Meier method was used to retrospectively analyze the patient’s OS,LFFS and DFFS.Log-rank test was used to analyze the differences between groups.P<0.05 was considered statistically significant.ResultsA total of 187 patients met the inclusion criteria,of which 98 patients treated with CRT-alone,and 89 patients treated with CRT-AC.Except for gender and the number of concurrent chemotherapy cycles,there was no significant difference in the characteristics between the CRT-alone and CRT-AC groups.After receiving CRT,50 patients achieved complete response(CR),67 patients achieved partial response(PR),63 patients remained stable disease(SD)and 7 patients had progression of disease(PD).The overall 1-year,2-year,and 5-year OS,LFFS and DFFS were 67.5,41.4 and 27.2%,68.7,57.9 and 52.4%,78.5,68.9 and 63.9%,respectively.Univariate analysis showed that the tumor site,age,N stage,M stage,clinical TNM stage and the short-term response to CRT were the significant factors that influenced the prognosis of patient(P<0.05).Multivariate analysis showed that N stage,M stage,and short-term response to CRT are the prognostic factors that influenced OS.The N stage and short-term response to CRT are the prognostic factors that influenced LFFS.While N stage and M stage are the prognostic factors that influenced DFFS.However,further stratified analysis showed that OS,LFFS or DFFS were not statistically significant among the CRT-alone groups and CRT-AC groups.ConclusionsThe short-term response to CRT,N stage,and M stage were significant prognosis factors for patients with ESCC treated with CRT.AC did not improve the OS of patients with ESCC treated with CRT.Because this study is retrospective,further prospective large-scale clinical studies are needed to evaluate the role of AC in patients with ESCC treated with CRT.