Propensity score matching analytical results of the impacts of different radiotherapy modalities on the prognosis of patients with esophageal squamous cell carcinoma
Objective To explore the impacts of two radiotherapy modalities,elective nodal irradiation(ENI)and involved-field irradiation(IFI),on the prognosis of patients with clinical T1～4N0M0 esophageal squamous cell carcinoma(ESCC)treated with definitive(chemotherapy)radiotherapy.Methods A retrospective analysis was conducted on the prognosis of 324 patients with clinical T1-4N0M0 ESCC,focusing on the impacts of ENI and IFI on the prognosis of these patients.Propensity score matching(PSM)analysis was performed based on the different composition ratios of the two groups,and stratified analysis was conducted for patients of different stages.Results All the patients presented a median overall survival(OS)of 33.1 months(95％CI:28.1-38.1)and a median progression-free survival(PFS)of 22.3 months(95％CI:18.2-26.4).There were 97 patients in the ENI group and 227 patients in the IFI group.The ENI group exhibited higher OS and PFS than the IFI group(x2=4.31,4.10,P＜0.05).After 1∶1 PSM analysis,each of the groups contained 75 cases.Multivariate analysis revealed that independent factors affecting patient OS included patient age,gross tumor volume(GTV),and irradiation modality(x2=7.93,5.88,4.59,P＜0.05)and PFS(x2=7.10,5.26,3.39,P＜0.05).Further stratified analysis indicated that ENI yielded significantly better efficacy than IFI for patients with cT1 and T2stage ESCC(x2=9.41,7.88,P＜0.05).However,this advantage was not found in T3 and T4 patients(P＞0.05).There was no statistically significant difference in the incidence of radiation esophagitis and radiation pneumonia between both groups(P＞0.05).Conclusions Patients with clinical T1-4N0M0 ESCC who undergone definitive(chemotherapy)radiotherapy may benefit from ENI,particularly those in the cT1 and cT2 stages,for whom ENI is recommended for definitive radiotherapy.
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