Cancer Management and Research (Jun 2020)

Antibiotics Modulate Chemotherapy Efficacy in Patients with Esophageal Cancer

  • Wu C,
  • Lai R,
  • Li J,
  • Zhang J,
  • Zhao Y,
  • Zhang X,
  • Zhao Y,
  • Guo Z

Journal volume & issue
Vol. Volume 12
pp. 4991 – 4997

Abstract

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Chensi Wu,1,2 Ruixue Lai,1 Jing Li,3 Jingjing Zhang,1 Yufei Zhao,1 Xiaoyun Zhang,1 Yue Zhao,2 Zhanjun Guo1 1Department of Immunology and Rheumatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Department of Gastroenterology and Hepatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 3College of Integrated Chinese and Western Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of ChinaCorrespondence: Zhanjun Guo Tel +86 311 86095342Fax +86 311 86086919Email [email protected]: Accumulating evidence suggests that microbiota dysbiosis induced by antibiotic administration plays a crucial role in regulating the efficacy and toxicity of cancer therapy. We explored the influence of antibiotic administration on the efficacy of chemotherapy in patients with esophageal cancer (EC).Patients and Methods: EC patients were stratified into two groups: antibiotic-treated group and control group. The antibiotic-treated group included patients who received antibiotics within 60 days before or after chemotherapy initiation, and the control group included patients who did not receive antibiotics within 60 days before or after chemotherapy initiation. Progression-free survival (PFS) and overall survival (OS) curves were constructed using the Kaplan–Meier method. The Cox proportional hazards model was used for univariate and multivariate analyses.Results: The rate of primary progressive disease in the antibiotic-treated group was significantly higher than that in the control group (36.58% vs 10.45%, p = 0.002) as calculated using the chi-square test. Further, antibiotic administration was associated with shorter PFS (6.7 vs 14.6 months, hazard ratio (HR): 2.545, 95% confidence interval (CI): 1.554– 4.168, p < 0.001) and reduced OS (15.0 vs 21.0 months, HR: 2.007, 95% CI: 1.213– 3.319, p = 0.007) in univariate analysis. Subsequent multivariate analysis indicated that antibiotic administration was a significant independent prognostic factor for PFS (HR: 2.350, 95% CI: 1.423– 3.882, p = 0.001) and OS (HR: 1.900, 95% CI: 1.140– 3.167, p = 0.014).Conclusion: Antibiotic administration was associated with reduced chemotherapy efficacy and poor prognosis in patients with EC.Keywords: esophageal cancer, antibiotics, PFS, OS

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