Liu S, Huang L P, Lin Z, Liu Y F, Zheng Z R, Peng X E, Chen W L, Hu Z J
School of Public Health, Fujian Medical University, Fuzhou 350100, China.
Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China.
Zhonghua Zhong Liu Za Zhi. 2019 Feb 23;41(2):124-128. doi: 10.3760/cma.j.issn.0253-3766.2019.02.009.
To investigate the association between the time of neutrophils to the lowest and prognosis of patients with esophageal squamous cell carcinoma (ESCC) treated with non-operative therapy. The clinical data of 325 non-operative treated ESCC patients were collected in this study. The X-title software was applied to establish optimal threshold of neutrophil reduction to the lowest value. According to the optimal threshold, the patients were divided into early group (115 cases) and late group (210 cases). The clinical features and survival time of the two groups were compared, and the factors of prognosis were analyzed by Cox regression model with univariate and multivariate analysis. The X-title software demonstrated the optimal cutoff values for the time of neutrophils to the lowest was 39 days. The median overall survival time was 21.0 months in the early group which was significantly higher than that in the late group (16.0 months). Multivariate Cox regression analysis showed that the treatment methods and the time of neutrophils to the lowest were independent factors for overall survival of patients with ESCC treated by non-surgical therapy. Compared with radiotherapy alone, concurrent chemoradiation could benefit the survival (=0.64, =0.026). The prognosis of patients in the late group of neutrophils to the lowest (=1.38, =0.038) was poor compared with the early group. Furthermore, stratified by treatment methods, the overall survival of two groups showed statistically significant difference only in patients received concurrent chemoradiation. The mortality risk in the late group was higher than that in the early group (=3.53, =0.010). The time of neutrophils to the lowest is an independent prognosis factor for non-operative treated ESCC patients. The prognosis of patients in the early group is better than that in the late group.
探讨非手术治疗的食管鳞状细胞癌(ESCC)患者中性粒细胞降至最低水平的时间与预后的关系。本研究收集了325例接受非手术治疗的ESCC患者的临床资料。应用X-title软件确定中性粒细胞降至最低值的最佳阈值。根据最佳阈值,将患者分为早期组(115例)和晚期组(210例)。比较两组的临床特征和生存时间,并采用Cox回归模型进行单因素和多因素分析以分析预后因素。X-title软件显示中性粒细胞降至最低水平的最佳截断值为39天。早期组的中位总生存时间为21.0个月,显著高于晚期组(16.0个月)。多因素Cox回归分析显示,治疗方法和中性粒细胞降至最低水平的时间是接受非手术治疗的ESCC患者总生存的独立因素。与单纯放疗相比,同步放化疗可改善生存(=0.64,=0.026)。中性粒细胞降至最低水平较晚组患者的预后(=1.38,=0.038)较早期组差。此外,按治疗方法分层,两组的总生存仅在接受同步放化疗的患者中存在统计学差异。晚期组的死亡风险高于早期组(=3.53,=0.010)。中性粒细胞降至最低水平的时间是接受非手术治疗的ESCC患者的独立预后因素。早期组患者的预后优于晚期组。