Effect of Consolidation Chemotherapy on Prognosis of StageⅡ-Ⅲ Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Concurrent Chemotherapy and Radio-therapy

Background The improvement efficacy of consolidation chemotherapy after definitive concurrent chemotherapy and radio-therapy (CCRT) on the prognosis of patients with locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In addition, there is a lack of nutritional risk screening tools which can consistently and accurately predict the survival of patients with esophageal cancer. Objective To investigate the effect of consolidation chemotherapy on the prognosis of patients with locally advanced ESCC receiving definitive CCRT. Methods A total of 223 patients with ESCC who received definitive CCRT in the department of radiotherapy, the Fourth Hospital of Hebei Medical University from January 2013 to December 2018 were selected as the research objects and divided into the simple CCRT group (n=87) and combined consolidation chemotherapy group (n=136) according to chemoradiotherapy regimen adopted by the patients. General data, ECOG score, tumor site, tumor length, TNM stage, radiotherapy dose, irradiation mode and chemotherapy regimen of the included patients were collected by electronic medical record system. Nutritional Risk Screening 2002 (NRS 2002) was used to score the nutritional status of the patients before chemoradiotherapy. Efficacy evaluation was performed within 1 month after CCRT, including complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). Patients were followed up by telephone (completed by the follow-up center) and outpatient review until 2022-09-30, with overall survival (OS), local relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS) collected. Survival curves of OS, LRRFS and DMFS were plotted by Kaplan-Meier method and compared by Log-rank test. Univariate and multivariate Cox risk regression models were used to explore the influencing factors of patient prognosis. Results There was no significant difference in baseline data between the simple CCRT group and combined consolidation chemotherapy group (P>0.05). There was no significant difference in the rates of OS, LRRFS and DMFS between the two groups (χ2=1.942, 0.743, 1.272; P=0.163, 0.389, 0.259). There were significant differences in the rates of OS, LRRFS and DMFS between patients with NRS 2002 score