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Comment & Response
February 6, 2020

Using Real-world Historical Controls to Evaluate Radiation Dose Escalation in Esophageal Cancer

Author Affiliations
  • 1Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong Academy of Medical Sciences, Shandong First Medical University, Jinan, China
  • 2Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Oncol. 2020;6(4):583. doi:10.1001/jamaoncol.2019.6406

To the Editor Chen et al1 are commended for reporting the final results of a phase 1/2, single-arm trial of chemoradiotherapy with a simultaneous integrated boost of radiotherapy dose as treatment for unresectable locally advanced esophageal cancer. The authors presented exploratory comparisons with an institutional cohort of 97 patients who received standard-dose radiotherapy and found that patients who received a simultaneous integrated boost of radiation had superior local control and overall survival. Although we appreciate the intention of using historical controls to augment evidence generated from single-arm trials, we note that such analyses and reporting require careful planning and rigorous disseminations.2

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