Induction chemotherapy plus chemoradiotherapy in esophageal cancer: long-term results and exploratory analyses of a randomized controlled trial

作者：Shiliang Liu, Baoqing Chen, Yujia Zhu, Sifen Wang, Xingyuan Cheng, Ruixi Wang, Yonghong Hu, Hui Liu, Qiaoqiao Li, Li Zhang, Lei Zhao, Mengzhong Liu, Mian Xi · 发表于：The Oncologist · 年份：2024 · DOI：10.1093/oncolo/oyae295 · 被引用次数：7 · 研究领域：Esophageal Cancer Research and Treatment、Esophageal and GI Pathology、Head and Neck Cancer Studies

BACKGROUND: Previous results of our trial demonstrated that the addition of induction chemotherapy (IC) prior to definitive chemoradiotherapy (CRT) failed to significantly improve the response rate or 3-year survival in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Here, we report long-term results and exploratory analyses to further evaluate the therapeutic value of IC. METHODS: Patients with previously untreated, unresectable, stage II-IVA ESCC were randomly assigned to receive IC followed by CRT or CRT alone. The relationship between tumor response to IC and long-term survival was analyzed. Baseline tumor biopsies were collected for RNA-Seq to identify patients who may benefit from IC. RESULTS: Eligible patients were randomized to either the IC + CRT group (n = 55) or the CRT group (n = 55). With a median follow-up of 74.9 months, the 5-year overall survival rate was 31.8% in the IC + CRT group and 29.1% in the CRT group (P =.675; HR, 0.91; 95% CI, 0.58-1.43). Similarly, no significant differences were identified in 5-year progression-free survival between groups (30.5% vs 25.5%, P =.508; HR, 0.86; 95% CI, 0.56-1.34). Patients who responded to IC had significantly better survival than nonresponders. A risk-score model incorporating 6 key genes to predict IC efficacy was also constructed. CONCLUSIONS: Compared with definitive CRT alone, the addition of IC before CRT still failed to demonstrate superior survival in patients with unselected ESCC, b...