期刊
CANCER RESEARCH AND TREATMENT
卷 53, 期 1, 页码 172-183出版社
KOREAN CANCER ASSOCIATION
DOI: 10.4143/crt.2020.594
关键词
Esophageal squamous cell carcinoma; Neoadjuvant chemoradiotherapy; Pathologic response; Prediction model; Hematological biomarker
类别
资金
- Fundamental Research Funds for the Central Universities [19ykpy176]
- Medical Scientific Research Foundation of Guangdong Province [C2015030]
- Natural Science Foundation of Guangdong Province [2019A1515011420]
This study developed a nomogram to predict pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) in esophageal squamous cell carcinoma (ESCC) patients by incorporating hematological biomarkers and clinico-pathological characteristics. The nomogram showed good predictive performance, providing valuable insights for treatment decisions.
Purpose This study aimed to develop a nomogram for predicting pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC) by integrating hematological biomarkers and clinico-pathological characteristics. Materials and Methods Between 2003 and 2017, 306 ESCC patients who underwent neoadjuvant CRT followed by esophagectomy were analyzed. Besides clinicopathological factors, hematological parameters before, during, and after CRT were collected. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for pCR. A nomogram model was built and internally validated. Results Absolute lymphocyte count (ALC), lymphocyte to monocyte ratio, albumin, hemoglobin, white blood cell, neutrophil, and platelet count generally declined, whereas neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) increased significantly following neoadjuvant CRT. After surgery, 124 patients (40.5%) achieved a pCR. The pCR group demonstrated significantly more favorable survival than the non-pCR group. On multivariate analysis, significant factors associated with pCR included sex, chemotherapy regimen, post-CRT endoscopic finding, pre-CRT NLR, ALC nadir during CRT, and post-CRT PLR, which were incorporated into the prediction model. The nomogram indicated good accuracy in predicting pCR, with a C-index of 0.75 (95% confidence interval, 0.71 to 0.78). Conclusion Female, chemotherapy regimen of cisplatin/vinorelbine, negative post-CRT endoscopic finding, pre-CRT NLR (<= 2.1), ALC nadir during CRT (> 0.35x10(9)/L) and post-CRT PLR (<= 83.0) were significantly associated with pCR in ESCC patients treated with neoadjuvant CRT. A nomogram incorporating hematological biomarkers to predict pCR was developed and internally validated, showing good predictive performance.
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