Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki Chuo, Kobe, 650-0017, Japan.
Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center, Tokyo, Japan.
Int J Clin Oncol. 2017 Dec;22(6):1042-1049. doi: 10.1007/s10147-017-1154-6. Epub 2017 Jul 17.
The aim of this study was to investigate the possible prognostic factors and predictive accuracy of the Glasgow Prognostic Score (GPS) for patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) treated with chemoradiotherapy.
One hundred forty-two patients were enrolled in JCOG0303 and assigned to the standard cisplatin and 5-fluorouracil (PF)-radiotherapy (RT) group or the low-dose PF-RT group. One hundred thirty-one patients with sufficient data were included in this analysis. A Cox regression model was used to analyze the prognostic factors of patients with unresectable LAESCC treated with PF-RT. The GPS was classified based on the baseline C-reactive protein (CRP) and serum albumin levels. Patients with CRP ≤1.0 mg/dL and albumin ≥3.5 g/dL were classified as GPS0. If only CRP was increased or only albumin was decreased, the patients were classified as GPS1, and the patients with CRP >1.0 mg/dL and albumin <3.5 g/dL were classified as GPS2.
The patients' backgrounds were as follows: median age (range), 62 (37-75); male/female, 119/12; ECOG PS 0/1/2, 64/65/2; and clinical stage (UICC 5th) IIB/III/IVA/IVB, 3/75/22/31. Multivariable analyses indicated only esophageal stenosis as a common factor for poor prognosis. In addition, overall survival tended to decrease according to the GPS subgroups (median survival time (months): GPS0/GPS1/GPS2 16.1/14.9/8.7).
Esophageal stenosis was identified as a candidate stratification factor for randomized trials of unresectable LAESCC patients. Furthermore, GPS represents a prognostic factor for LAESCC patients treated with chemoradiotherapy.
UMIN000000861.
本研究旨在探讨不可切除局部晚期食管鳞状细胞癌（LAESCC）患者接受放化疗后格拉斯哥预后评分（GPS）的可能预后因素和预测准确性。
142 例患者入组 JCOG0303 并被分配至标准顺铂和 5-氟尿嘧啶（PF）-放疗（RT）组或低剂量 PF-RT 组。131 例数据充足的患者纳入本分析。采用 Cox 回归模型分析接受 PF-RT 的不可切除 LAESCC 患者的预后因素。根据基线 C 反应蛋白（CRP）和血清白蛋白水平对 GPS 进行分类。CRP≤1.0mg/dL 和白蛋白≥3.5g/dL 的患者被归类为 GPS0。仅 CRP 升高或仅白蛋白降低的患者被归类为 GPS1，CRP>1.0mg/dL 和白蛋白<3.5g/dL 的患者被归类为 GPS2。
患者的背景如下：中位年龄（范围），62（37-75）；男/女，119/12；ECOG PS 0/1/2，64/65/2；临床分期（UICC 第 5 版）IIB/III/IVA/IVB，3/75/22/31。多变量分析表明，仅食管狭窄是预后不良的共同因素。此外，根据 GPS 亚组，总生存率呈下降趋势（中位生存时间（月）：GPS0/GPS1/GPS2 为 16.1/14.9/8.7）。
食管狭窄被确定为不可切除 LAESCC 患者随机试验的候选分层因素。此外，GPS 是接受放化疗的 LAESCC 患者的预后因素。
UMIN000000861。
