Lv Jun, Gan Huimin, Zhang Wei, Pan Linjiang, Wang Rensheng, Qin Yutao
Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University.
Radiation Oncology Clinical Medical Research Center of Guangxi, Nanning 530021, Guangxi, China.
Medicine (Baltimore). 2019 Apr;98(14):e14963. doi: 10.1097/MD.0000000000014963.
The present study is to evaluate the significance in prognosis of relative tumor volume (RTV) in patients with non-resectable esophageal squamous cell carcinoma (ESCC) treated by definitive radiotherapy alone or in combination with chemotherapy.Fifty-eight consecutive patients with ESCC in UICC stage I to IV were retrospectively analyzed. Relative primary gross volume (RGTVp) was defined as primary gross volume (GTVp) divided by body volume. Relative primary gross volume for lymph nodes (RGTVnd) was defined as primary gross volume for lymph nodes (GTVnd) divided by body volume. The relationships were analyzed between overall survival (OS), disease free survival (DFS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and RGTVp (RGTVnd) in univariate and multivariate analyses.The cut-off values of 0.947 and 0.007 were determined for RGTVp and RGTVnd, respectively. The 3-year OS, DFS, and LRFS for patients with RGTVp ≤ 0.947 vs RGTVp > 0.947 was 65.4% vs 25.0% (P = .001), 46.2% vs 12.5% (P = .002), and 90.1% vs 42.0% (P < .001). RGTVp was an independent risk factor for OS (P = .046), DFS (P = .015) and LRFS (P = .032), but showed no association with DMFS in univariate and multivariate analyses. The 3-year DFS and DMFS for patients with RGTVnd ≤ 0.007 vs RGTVnd > 0.007 was 44.4% vs 20.0% (P = .023), and 62.9% vs 24.6% (P < .004). RGTVnd was associated with DMFS (P = .012) in multivariate, but showed no associated with DFS.The present study demonstrates that RTV was an independent factor relevant to prognosis for ESCC. It provides new clinical basis for personalized therapeutic regimens and might be included in the staging system.
本研究旨在评估单纯根治性放疗或联合化疗治疗的不可切除食管鳞状细胞癌（ESCC）患者中，相对肿瘤体积（RTV）对预后的意义。对58例连续的国际抗癌联盟（UICC）I至IV期ESCC患者进行回顾性分析。相对原发大体积（RGTVp）定义为原发大体积（GTVp）除以体体积。淋巴结相对原发大体积（RGTVnd）定义为淋巴结原发大体积（GTVnd）除以体体积。在单因素和多因素分析中分析总生存期（OS）、无病生存期（DFS）、局部无复发生存期（LRFS）、远处无转移生存期（DMFS）与RGTVp（RGTVnd）之间的关系。分别确定RGTVp和RGTVnd的截断值为0.947和0.007。RGTVp≤0.947与RGTVp＞0.947患者的3年OS、DFS和LRFS分别为65.4%对25.0%（P = 0.001）、46.2%对12.5%（P = 0.002）和90.1%对42.0%（P＜0.001）。在单因素和多因素分析中，RGTVp是OS（P = 0.046）、DFS（P = 0.015）和LRFS（P = 0.032）的独立危险因素，但与DMFS无关。RGTVnd≤0.007与RGTVnd＞0.007患者的3年DFS和DMFS分别为44.4%对20.0%（P = 0.023）和62.9%对24.6%（P＜0.004）。在多因素分析中，RGTVnd与DMFS相关（P = 0.012），但与DFS无关。本研究表明，RTV是与ESCC预后相关的独立因素。它为个性化治疗方案提供了新的临床依据，可能会被纳入分期系统。
