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Yuanliu Nie,1 Guangyue Yao,1 Liang Li,2 Alei Feng,3 Wentao Zhang,4 Xiaoying Xu,5 Qiang Li,1,3 Zhe Yang1,3 1Tumor Research and Therapy Center, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, 250021, Peopleâs Republic of China; 2Department of Thoracic Surgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, 250021, Peopleâs Republic of China; 3Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, Peopleâs Republic of China; 4Shandong First Medical University, Jinan, Shandong, 250021, Peopleâs Republic of China; 5Shandong First Medical University, College of Basic Medicine, Shandong First Medical University-Shandong Academy of Medical Sciences, Jinan, Shandong, 250000, Peopleâs Republic of ChinaCorrespondence: Qiang Li; Zhe Yang, Tumor Research and Therapy Center, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, 250021, Peopleâs Republic of China, Tel +86 15053162586; +86 13791089059, Email lq1211@126.com; sdslyyyz@sina.comPurpose: The present study assessed the effects of radiotherapy on overall survival (OS) and progression-free survival time (PFS) in patients with stage II or higher esophageal cancer receiving immunotherapy; evaluated factors independently prognostic of OS and PFS in these patients; and utilized these factors to establish a prognostic nomogram.Patients and Methods: This study enrolled 134 patients with stage II or higher esophageal cancer treated with chemotherapy (platinum-based agents plus paclitaxel or fluorouracil) and immunotherapy. These patients were divided into two groups, a radiotherapy (RT) group (n = 55) and a non-radiotherapy (non-RT) group (n = 79). Following 1:1 propensity score matching, OS and PFS were compared by the KaplanâMeier method, and factors associated with survival were determined by univariate and multifactorial Cox regression analyses. These factors were used to construct a prognostic nomogram.Results: After propensity matching, all covariates were well balanced in the two groups (all P > 0.05). After matching, both median PFS (15.70 months [95% confidence interval (CI) 8.68â 22.72 months] vs 5.70 months [95% CI 3.38â 8.02 months], P = 0.002) and median OS (15.72 months [95% CI 12.94â 18.46 months] vs 12.06 months [95% CI 9.91â 14.20 months], P = 0.036) were significantly longer in the RT than in the non-RT group. Univariate and multifactorial analyses showed that RT, neutrophil-lymphocyte ratios, and tumor differentiation were independently prognostic of OS, with all hazard ratios (HRs) < 1 and all P-values < 0.05. A nomogram based on these factors was constructed, and its accuracy was verified.Conclusion: Immunotherapy plus RT resulted in better survival outcomes than immunotherapy alone. A nomogram based on prognostic factors can guide personalized treatment and monitor prognosis.Keywords: prognosis, combination therapy, survival, neutrophil-lymphocyte ratio, NLR |
