Concurrent β-blocker use is Associated With Improved Survival In Esophageal Adenocarcinoma Patients Who Undergo Definitive Chemoradiation: A Retrospective Matched Pair Analysis

Abstract

β-blocker use has been associated with improved outcomes in a number of different malignancies; however, this association has not been studied in patients with esophageal cancer. We compared the outcomes of esophageal adenocarcinoma patients based on β-blocker usage. The charts of all 418 patients treated with radiation for esophageal cancer at our institution from April 2010 to October 2018 were analyzed. Patients who underwent treatment with palliative intent or non-adenocarcinoma histology were excluded. β-blocker use was determined from the medication list at time of pre-treatment consultation. There were 246 adenocarcinoma patients who received neoadjuvant/definitive CRT. The median follow-up for the cohort was 22 months (interquartile range (IQR) 9.6-41.0 months). Within the cohort, 27.6% (n = 68) of patients were taking β-blockers at the time of treatment. In all patients, there was no significant relationship between β-blocker use and progression-free survival (PFS) or overall survival (OS). However, concomitant β-blocker use was significantly associated with improved PFS and OS among patients who underwent definitive chemoradiation therapy (CRT). In the definitive CRT adenocarcinoma cohort, after matching patients for tumor stage, nodal stage, Karnofsky performance status, and age, 32 matched pairs were created. This matched pair analysis showed a significant PFS (p = 0.04) and OS benefit (p = 0.04) for adenocarcinoma patients taking β-blockers. Concurrent β-blocker use is common within patients receiving concurrent chemoradiation for esophageal adenocarcinoma. Adenocarcinoma patients who received definitive chemoradiation while taking β-blockers demonstrated significant PFS and OS benefits.