Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers
Autor: | Jinbin Chen, Qiaoqiao Li, Hong Yang, Yingjia Wu, Lei Zhao, Suping Guo, Jinhan Zhu, Mian Xi |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male Cancer Research medicine.medical_specialty genetic structures Lymphocyte medicine.medical_treatment Vinorelbine Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Esophageal squamous cell carcinoma Prediction model White blood cell Internal medicine Gastrointestinal Cancer Biomarkers Tumor medicine Humans Neutrophil to lymphocyte ratio Aged business.industry Hematological biomarker Chemoradiotherapy Middle Aged Nomogram Chemotherapy regimen Neoadjuvant Therapy Confidence interval Neoadjuvant chemoradiotherapy Pathologic response medicine.anatomical_structure Oncology Esophagectomy 030220 oncology & carcinogenesis Female Original Article business circulatory and respiratory physiology medicine.drug |
Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
ISSN: | 2005-9256 1598-2998 |
Popis: | 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 clinicopathological 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.ResultsAbsolute 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 (> 0.35 ×109/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. |
Databáze: | OpenAIRE |
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