Definitive concurrent chemoradiation (CCRT) is the standard treatment for cervical esophageal cancer and non-surgical candidates. Initial treatment response affects survival; however, few validated markers are available for prediction. This study evaluated the clinical variables and chemoradiation parameters associated with treatment response. Between May 2010 and April 2016, 86 completed CCRT patients’ clinical, dosimetric, and laboratory data at baseline and during treatment were collected. Cox regression analysis assessed the risk factors for overall survival (OS). A receiver operating characteristic curve with Youden’s index was chosen to obtain the optimal cut-off value of each parameter. Treatment response was defined per Response Evaluation Criteria in Solid Tumors v.1.1 at the first post-CCRT computed tomography scan. Responders had complete and partial responses; non-responders had stable and progressive diseases. Logistic regression (LR) was used to evaluate the variables associated with responders. The Cox regression model confirmed the presence of responders (n= 50) vs. non-responders (n= 36) with a significant difference in OS. In multivariate LR, cardiac dose–volume received ≥10 Gy; the baseline hemoglobin level, highest neutrophil to lymphocyte ratio during CCRT, and cumulative cisplatin dose were significantly associated with the responders. The initial clinical treatment response significantly determines disease outcome. Cardiac irradiation may affect the treatment response.
确定性同步放化疗（CCRT）是颈段食管癌及非手术适应症患者的标准治疗方案。初始治疗反应影响生存预后，然而目前可用于预测的有效生物标志物较少。本研究旨在评估与治疗反应相关的临床变量及放化疗参数。研究收集了2010年5月至2016年4月期间完成CCRT治疗的86例患者在基线期及治疗期间的临床资料、剂量学参数及实验室数据。采用Cox回归分析评估总生存期（OS）的风险因素，通过受试者工作特征曲线结合约登指数确定各参数的最佳截断值。治疗反应根据首次CCRT后计算机断层扫描结果，参照实体瘤疗效评价标准1.1版进行定义：应答者包括完全缓解和部分缓解；无应答者包括疾病稳定和疾病进展。采用逻辑回归（LR）分析与治疗应答相关的变量。Cox回归模型证实应答者（50例）与无应答者（36例）的总生存期存在显著差异。多因素逻辑回归分析显示：心脏受照剂量≥10 Gy的体积参数、基线血红蛋白水平、CCRT期间中性粒细胞与淋巴细胞比值峰值以及顺铂累积剂量与治疗应答显著相关。初始临床治疗反应对疾病转归具有决定性影响，心脏照射剂量可能影响治疗反应。
肿瘤(癌症)患者之家