Prospective Randomized Controlled Trial Of Adjuvant Chemoradiotherapy In Treatment Of Resectable Esophageal Squamous Cell Carcinoma

Objective: Depending on pathological stage,patients with esophageal squamous cell carcinoma(ESCC)have a poor prognosis after surgery.This study was designed to analyze the effect of various treatments on prognosis in patients who undergo radical surgery.Methods: This random-allocation,prospective study evaluated patients who had undergone right transthoracic esophagectomy for thoracic ESCC with pathologic stage pII-III(pT2-4aN0-1M0)between January 2013 and October 2015 at our institute.Based on the inclusion criteria and exclusion criteria,104 patients meet the criteria.According to the varied treatment and whether treating or not,they can divide into 3 parts,including the Surgery alone group(48 patients,treated surgery alone),Postoperative chemotherapy group(33 patients,treated postoperative chemotherapy),and Postoperative adjuvant chemoradiotherapy group(22 patients,treated Postoperative adjuvant chemoradiotherapy).After the follow-up period of 36 months,we counted the 3-year OS rates and the 3-year DFS rates of each groups and analyzed the effect of various treatments on prognosis in patients who undergo radical surgery.Results: The follow-up period is 36 months.We analyzed the clinical features of the 104 patients.The Age,Sex,Course,Severe comorbidity Disease,Tumor location,Length,Thickness,Tumor stage,Histological grade among the 3groups are not statistical significance(P>0.05).The 1-year OS rates of the patients in the surgery group,postoperative chemotherapy group,postoperative chemoradiotherapy group were 77.1%,78.8%,91.3% respectively.The 1-year DFS rates of the patients in the surgery group,postoperative chemotherapy group,postoperative chemoradiotherapy group were 75.0%,75.8%,78.3% respectively.Both the 1-year OS and the 1-year DFS of the patients among 3 group are not statistical significance(P>0.05).The 3-year OS rates of the patients in the surgery group,postoperative chemotherapy group,postoperative chemoradiotherapy group were 50.0%,54.5%,74.0% respectively.The 3-year DFS rates of the patients in the surgery group,postoperative chemotherapy group,postoperative chemoradiotherapy group were 45.8%,45.5%,62.2%,respectively.The 1-year OS and the 1-year DFS of the patients in the postoperative chemoradiotherapy group are not statistical significance contrasted with the patients in the surgery and postoperative chemotherapy group(P>0.05).The 3-year OS of the patients in the postoperative chemoradiotherapy group was better than that of the patients in the surgery group and the significance is statistical(P<0.05).The 3-year DFS of the patients in the postoperative chemoradiotherapy group are better than the patients in the surgery and postoperative chemotherapy group,but the significance is not statistical(P>0.05).Conclusion: This random-allocation,prospective study showed that postoperative adjuvant chemoradiotherapy was associated with the 3-year OS compared with postoperative chemotherapy or surgey alone.But long-term outcomes require longer follow-up observations.