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Antihistamines H1 use on survival outcomes in esophageal squamous cell carcinoma patients undergoing concurrent chemoradiotherapy.

ABSTRACT: Esophageal squamous cell carcinoma (ESCC) is a leading cause of cancer-related mortality in Taiwan, with poor survival rates despite standard treatment with concurrent chemoradiotherapy (CCRT). Antihistamines H1 (AH1) may have anticancer effects by reducing allergic reactions, activating mitogen-activated protein kinases, and regulating the immune system. However, the impact of AH1 use during CCRT on survival outcomes in patients with ESCC remains uncertain. A propensity score-matched cohort study was conducted using data from the Taiwan Cancer Registry Database and National Health Insurance Research Database. The primary outcome measures were overall survival and ESCC-specific survival. We analyzed the effects of AH1 use during CCRT on these outcomes using multivariable Cox proportional hazards regression models. The current study involved 981 individuals diagnosed with ESCC who underwent standard CCRT. Out of these, 309 were placed in the non-AH1 group and 672 in the AH1 group. AH1 use during CCRT was found to be associated with improved overall survival (adjusted hazard ratio [HR], 0.52; 95% CI, 0.44-0.60; P<0.0001) and ESCC-specific survival (adjusted HR, 0.47; 95% CI, 0.39-0.56; P<0.0001) compared with nonuse. A dose-response relationship was also observed, with higher cumulative defined daily doses of AH1 associated with lower mortality. The optimal daily intensity dose for AH1 use was found to be 0.84 defined daily doses with the lowest mortality. Our study demonstrates that AH1 use during CCRT for ESCC is associated with improved overall survival and ESCC-specific survival.

SUBMITTER: Chang CL

PROVIDER: S-EPMC10695773 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Antihistamines H1 use on survival outcomes in esophageal squamous cell carcinoma patients undergoing concurrent chemoradiotherapy.

Chang Chia-Lun CL Lin Kuan-Chou KC Chen Wan-Ming WM Shia Ben-Chang BC Wu Szu-Yuan SY

American journal of cancer research 20231115 11

Esophageal squamous cell carcinoma (ESCC) is a leading cause of cancer-related mortality in Taiwan, with poor survival rates despite standard treatment with concurrent chemoradiotherapy (CCRT). Antihistamines H1 (AH1) may have anticancer effects by reducing allergic reactions, activating mitogen-activated protein kinases, and regulating the immune system. However, the impact of AH1 use during CCRT on survival outcomes in patients with ESCC remains uncertain. A propensity score-matched cohort stu ...[more]

PMID: 38058841

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Project description:BackgroundDefinitive concurrent chemoradiotherapy (dCCRT) is suggested as the standard treatment for cervical esophageal squamous cell carcinoma (CESCC). This retrospective propensity study compared the 8-year survival outcomes and acute treatment toxicities of these patients treated with elective nodal irradiation (ENI) versus involved-field irradiation (IFI).Materials and methodsPatients with stage II-IV CESCC treated with dCCRT at the Fourth Hospital of Hebei Medical University between January 1, 2007 and December 31, 2020 were enrolled in the study. All the patients were restaged according to the American Joint Commission 8th edition criteria. The propensity score matching (PSM) was used to minimize the effects of treatment selection bias and potential confounding factors including sex, age, ECOG score, clinical T stage, clinical N stage, clinical TNM stage and radiation dose between the ENI group and IFI group. Survival and the prognostic factors were evaluated.ResultsThe 131 eligible patients underwent ENI (60 patients, 45.8%) or IFI (71 patients, 54.2%). The median follow-up time was 91.1 months (range, 23.8-182.0 months) for all the patients. The median OS, 1-, 3-, 5-, and 8-year OS rates were 44.4 months, 87.8%, 55.1%, 38.3%, and 27.2%, respectively. After PSM, there were 49 patients in each group. The median OS, 1-, 3-, 5-, and 8-year OS rates for ENI and IFI group were 32.0 months, 83.7%, 48.5%, 38.5% and 31.1% versus 45.2 months, 89.8%, 52.5%, 37.5%, 26.1%, respectively (P = 0.966; HR 0.99, 95% CI 0.61-1.61). Similar locoregional control was obtained in both groups. The tendency of leukocytopenia and neutropenia was higher in ENI than in IFI (59.2% vs. 38.8%; P = 0.068 and 30.6% vs. 14.3%; P = 0.089) at the end of dCCRT.ConclusionCervical esophageal squamous cell carcinoma patients undergoing definitive concurrent chemoradiotherapy has a satisfactory prognosis with organ conservation. The involved-field irradiation might be a better alternative owing to similar overall survival outcomes and local control with less toxicity of myelosuppression.

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Antihistamines H1 use on survival outcomes in esophageal squamous cell carcinoma patients undergoing concurrent chemoradiotherapy.

Publications

Antihistamines H1 use on survival outcomes in esophageal squamous cell carcinoma patients undergoing concurrent chemoradiotherapy.

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