Abstract 412P
Background
This study is to explore a more effective treatment model for patients with oligometastatic esophageal cancer (OMEC) presenting solely distant lymph node metastasis.
Methods
This cohort study retrospectively collected clinical data of patients with OMEC presenting solely distant lymph node metastasis. 107 patients were included in an institutional review board (IRB)-approved study, of which 35 received immunochemotherapy, 25 received concurrent radiochemotherapy and 47 received chemoradiotherapy combined with immunotherapy. Study endpoints were progression-free survival (PFS), overall survival (OS), treatment-related toxicities.
Results
A total of 107 patients were included, whom were diagnosed with squamous cell carcinoma histology and presented with synchronous OMEC with distant lymph node metastasis. Compared to patients receiving immunochemotherapy, chemoradiotherapy combined with immunotherapy significantly improved PFS (13.62 months vs. 6.65 months, P=0.0072), but not the OS (30.71 months vs. 31.0 months, P=0.4542). Compared with immunochemotherapy, concurrent radiochemotherapy offered significant OS (36.65 months vs. 31.0 months, P= 0.0169), but PFS was not significant (9.61 months vs. 6.65 months, p=0.2767). 19 (55.88%) patients in immunochemotherapy group, 19 (76.00%) patients in concurrent radiochemotherapy group and 42 (89.36%) patients in chemoradiotherapy combined with immunotherapy group developed grade ≥ 3 hematologic toxicities. Leukopenia is the most common hematologic toxicity. Compared with concurrent radiochemotherapy or immunochemotherapy, chemoradiotherapy combined with immunotherapy may increase hematologic or non-hematologic toxicity.
Conclusions
This study provides real-world evidence for the effectiveness of different treatment models on survival outcome in oligometastatic esophageal cancer with only distant lymph node metastasis. Comparing the three treatment options, concurrent radiochemotherapy can prolong the survival of patients with few adverse reactions. Although chemoradiotherapy combined with immunotherapy can prolong the PFS of patients, it should also prevent the occurrence of adverse events.
Legal entity responsible for the study
The authors.
Funding
National Natural Science Foundation of China.
Disclosure
All authors have declared no conflicts of interest.