High vs. low radiotherapy dose in locally advanced esophageal squamous cell carcinoma patients treated with neoadjuvant concurrent chemoradiotherapy: an endemic area population-based study

Chia-Chin Li; Chih-Yi Chen; Ying-Hsiang Chou; Chih-Jen Huang; Hsiu-Ying Ku; Ying-Chun Lin; Chun-Ru Chien

doi:10.1007/s12672-022-00594-y

High vs. low radiotherapy dose in locally advanced esophageal squamous cell carcinoma patients treated with neoadjuvant concurrent chemoradiotherapy: an endemic area population-based study

Discov Oncol. 2022 Nov 24;13(1):130. doi: 10.1007/s12672-022-00594-y.

Authors

Chia-Chin Li^#¹, Chih-Yi Chen^#^{2

3}, Ying-Hsiang Chou^#^{4

5}, Chih-Jen Huang^#⁶, Hsiu-Ying Ku^#^{7

8}, Ying-Chun Lin^#^{1

9}, Chun-Ru Chien^{10

11}

Affiliations

¹ Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.
² Division of Thoracic Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan.
³ Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
⁴ Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan.
⁵ Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁶ Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
⁷ National Institute of Cancer Research, National Health Research Institutes Miaoli, Miaoli County, Taiwan.
⁸ Department of Healthcare Administration, Asia University, Taichung, Taiwan.
⁹ School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, North District, Taichung, 40402, Taiwan.
¹⁰ Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan. d16181@gmail.com.
¹¹ School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, North District, Taichung, 40402, Taiwan. d16181@gmail.com.

^# Contributed equally.

Abstract

Background: The optimal radiotherapy dose for locally advanced esophageal squamous cell carcinoma in endemic areas treated with neoadjuvant concurrent chemoradiotherapy is unclear.

Methods: Eligible patients diagnosed between 2010 and 2019 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders. The hazard ratio (HR) of death was compared between high dose (50-50.4 Gy) and low dose (40-41.4 Gy) radiotherapy. We also evaluated other outcomes and performed supplementary analyses via an alternative approach.

Results: Our study population consisted of 644 patients. The PS weight-adjusted HR of death was 0.92 (95% confidence interval: 0.7-1.19, p = 0.51). There were no statistically significant differences for other outcomes or supplementary analyses.

Conclusions: In this population-based study from an endemic area, we found no significant difference in overall survival between high vs. low radiotherapy doses.

Keywords: Esophageal squamous cell carcinoma; Neoadjuvant concurrent chemoradiotherapy; Radiotherapy dose.