Concurrent chemoradiotherapy (CRT) is regarded as the standard treatment for inoperable esophageal cancers (EC). It is still controversial whether consolidation chemotherapy (CCT) or induction chemotherapy (IC) is beneficial for the patients who received CRT. Therefore, we carried out a retrospective analysis at our institution. A total of 186 inoperable EC patients from 20 October 2017 to 7 June 2021 who have previously received CRT were included in our study. The patients were divided into IC + CRT (n = 52), CCRT (n = 64), and CRT + CCT (n = 70) groups according to whether they received induction chemotherapy, consolidation chemotherapy, or not. We used Kaplan–Meier statistics to analyze their 1-, 2-, and 3-year OS. The median follow-up time for the whole group was 14.15 months. The 1-, 2-, 3- year overall survival (OS) for the CCRT group were 72.2%, 52.5%, and 29.5%, and 50.9%, 37.5%, and 25% for the IC + CRT group (p > 0.05). For the CRT + CCT group,1-, 2-, and 3-year OS were 89.8%, 59.0%, and 42.5% (p < 0.05). Adverse reactions in the three groups were mainly graded 0–3. The difference between the three groups was not statistically significant (p > 0.05). For non-surgical EC patients who received CRT, CCT after CRT but not IC before CRT can improve 1-, 2-, and 3-year OS with a low incidence of associated severe adverse effects. As a result, the addition of consolidation chemotherapy to chemoradiotherapy has significant prognostic advantages for inoperable EC patients.

Radiation-induced skin toxicity, resulting from ionizing or nonionizing radiation, is a common skin disorder. However, the underlying relationship between skin microbiota and radiation-induced skin toxicity remains largely unexplored. Herein, we uncover the microbiota–skin interaction based on a genome-wide association study (GWAS) featuring 150 skin microbiota and three types of skin microenvironment. Summary datasets of human skin microbiota were extracted from the GWAS catalog database, and summary datasets of radiation-induced skin toxicity from the FinnGen biobank. Mendelian Randomization (MR) analysis was leveraged to sort out the causal link between skin microbiota and radiation-induced skin toxicity. We identified 33 causal connections between human skin microbiota and radiation-induced skin toxicity, including 19 positive and 14 negative causative directions. Among these potential associations, the genus Staphylococcus could serve as a common risk factor for radiation-induced skin toxicity, especially for radiodermatitis. And Streptococcus salivarius was identified as a potential protective factor against radiation-induced skin toxicity. Additional analysis indicated no pleiotropy, heterogeneity, or reverse causal relationship in the results. We comprehensively assessed potential associations of skin microbiota with radiation-induced skin toxicity and identified several suggestive links. Our results provide promising targets for the prevention and treatment of radiation-induced skin toxicity.

The optimal radiotherapy dose for cervical and upper thoracic esophageal cancer (ESCA) remains controversial, with limited evidence supporting dose escalation. This study aims to evaluate the survival impact of varying radiotherapy doses and explore potential benefits in specific patient subgroups using multicenter real-world data.Data from 2,527 inoperable cervical and upper thoracic ESCA patients treated with IMRT/3DCRT across eight medical centers in China during 1st June 2004 and 1st June 2020 were retrospectively analyzed. Patients were divided into low-dose (50–<60 Gy) and high-dose (≥ 60 Gy) groups. Subgroup analyses were conducted to identify populations that might benefit from higher doses.High-dose radiotherapy (≥ 60 Gy) improved overall survival (OS) in cervical ESCA patients before and after propensity score matching (P = 0.026 and P = 0.047). For upper thoracic ESCA, high-dose radiotherapy showed a survival advantage before matching (P = 0.008), though not after (P = 0.680). Subgroup analysis revealed survival benefits in upper thoracic ESCA patients with poor performance status (KPS < 90), those not receiving chemotherapy (P = 0.043 and P = 0.013), and borderline improvement in patients with smaller gross tumor volumes (< 35.1 cm³, P = 0.057). Radiation doses exceeding 63 Gy provided no additional survival benefit compared to 60–63 Gy.High-dose radiotherapy (≥ 60 Gy) significantly improves survival in cervical ESCA patients. Subgroup analysis highlights its potential benefits for upper thoracic ESCA patients with KPS < 90, those not receiving chemotherapy, and those with smaller tumor volumes (< 35.1 cm³).