| Objective:The clinical characteristics of patients with non-operative locally advanced squamous cell carcinoma of the esophageal treated with chemoradiotherapy were investigated retrospectively in order to identify the factors that influence patient survival.Methods:This retrospective studied included 101 patients with locally advanced squamous cell carcinoma of the esophageal that received radiotherapy and met the inclusion criteria during January 2014 and December 2019.Collect clinical patient data,such as age,gender,smoking and alcohol use habits,tumor location and size,clinical stage,degree of differentiation,radiation dose,concurrent chemotherapy and chemotherapy regimen.The X~2 test was used to compare clinical features such as age,gender and degree of differentiation,while the Kaplan-Meier method was employed to depict patients’ long-term survival curves.The log-rank test was used to examine univariate clinical variables such as age,gender,smoking and drinking history,level of differentiation,clinical stage,tumor location,tumor length,radiotherapy dose and concurrent chemotherapy.If P < 0.05,it was included in the multifactor analysis(Cox regression model).If P < 0.05 in the multivariate regression analysis,it indicated that the variable had statistical significance and was an independent factor affecting prognosis.Results:The median survival time among all patients was 17.0 months,1-year rate of survival(OS)was 67.3%,2-year rate of survival was 41.6%,and a 3-year survival rate of 26.7%.In the univariate analysis,the eight clinical characteristics of age(P=0.045),gender(P=0.049),tumor location(P=0.015),degree of differentiation(P<0.001),tumor length(P=0.038),T-stage(P=0.008),clinical stage(P=0.031)and concurrent chemotherapy(P=0.044)were P<0.05.In Cox multivariate analysis,P <0.05 was found for gender,tumor location,degree of differentiation and T stage,which were independent factors that influence patient prognosis.Patients who received or did not receive concurrent chemotherapy were analyzed,the median survival time in the concurrent chemotherapy group was 27 months,with 1-,2-,and 3-year OS of 86.1%,55.6%,and 41.7%,respectively,and the median survival time in the non-concurrent chemotherapy group was 14 months,with 1-,2-,and 3-year OS of 56.9%,33.8%,and 18.5%,respectively,P=0.044,showed a statistically significant difference.In the study of radiation therapy dose subgroups.the median survival time in the ≤60 Gy group was 16 months,with 62.5%,37.5%,and 23.2% for 1,2,and 3-year OS,in both,and the median survival time in the >60Gy group was 20 months,with 73.3%,46.7%,and 31.1% for 1,2,and 3-year OS,respectively,P=0.349,without a statistically significant difference.While patients with and without induction chemotherapy were compared,the median survival time in the induction chemotherapy group was 16 months,with 1-,2-,and 3-year OS of 66.7%,39.7%,and 27%,respectively,and the median survival time in the non-induction chemotherapy group was 18 months,with 1-,2-,and 3-year OS of 68.4%,44.7%,and 26.3%,respectively,P=0.938,meaning there was no statistically significant difference.In the analysis of patients with or without consolidation chemotherapy,the median survival time was 20 months in the group with consolidation chemotherapy and 15 months in the group without consolidation chemotherapy.OS for 1,2 and 3 years was 75.8%,48.5%,39.4% and 63.2%,38.2%,20.6% in the consolidation chemotherapy and no consolidation chemotherapy groups,respectively,P=0.137,with no significant difference between the two groups.Patients with an overall survival time ≥ 24 months and those with a survival time < 24 months were analyzed to compare their clinical characteristics.Age(P=0.037),gender(P=0.018),degree of differentiation(P < 0.001),T stage(P=0.020),clinical stage(P=0.032),and concurrent chemotherapy(P=0.034)were statistically significant(P <0.05).Conclusion:1.The median overall survival(mOS)for 101 patients with locally advanced squamous cell cancer of the oesophagus was 17.0 months,with overall survival rates of 67.3%,41.6%,and 26.7% at 1,2,and 3 years,respectively.2.Gender,tumor site,degree of differentiation,and T stage were all independent indicators of survival overall for patients with locally progressed esophageal squamous cell carcinoma who underwent radiotherapy.3.Patients with locally advanced oesophagus squamous cell cancer who were female,had tumor location in the cervical segment,were highly differentiated,and had a T stage of T2 had a better survival prognosis.4.Age,sex,degree of differentiation,T-stage,clinical stage,and concurrent chemotherapy were linked with long-term survival in patients treated with radiation for locally advanced esophageal squamous cell carcinoma. |
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