Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Gut Liver. 2020 Jul 15;14(4):450-458. doi: 10.5009/gnl19165.
BACKGROUND/AIMS: Several clinical factors have been used to predict the response for concurrent chemoradiotherapy (CCRT); however, these factors are insufficient for prognostic predictions. We investigated clinical factors to assess whether they could be used to predict the response to CCRT and the survival of patients with esophageal cancer.
Patients with esophageal cancer underwent CCRT from January 2005 to December 2015. Response to CCRT was classified as progressive disease (PD), stationary disease (SD), partial remission (PR), or complete remission (CR). Factors to predict the response to CCRT and patient survival were subsequently investigated.
A total of 535 esophageal cancer patients underwent CCRT. Four hundred ninety-three patients were followed up, and patient outcomes were investigated. In the adjusted analysis, patients with advanced stage disease (relative risk [RR], 0.28 in stage III and 0.12 in stage IV compared to stage I), poor performance status, circumferential involvement (RR, 0.61), and male sex (RR, 0.31) were less likely to achieve CR. Advanced stage disease (hazard ratio [HR], 1.71 in stage III/IV), poor CCRT response (HR, 2.82 in PR, 4.47 in SD, 4.77 in PD compared to CR), and poor performance status (HR, 1.38 in ECOG 2-4) were found to increase mortality.
Advanced stage disease, poor performance status, male sex, and circumferential involvement were independent predictive factors for a poor response to CCRT. Advanced stage, poor performance status, and poor CCRT response were independent factors for decreased survival.
背景/目的：有几种临床因素已被用于预测同步放化疗（CCRT）的反应；然而，这些因素不足以进行预后预测。我们研究了临床因素，以评估它们是否可用于预测食管癌患者对 CCRT 的反应和生存。
2005 年 1 月至 2015 年 12 月期间，患有食管癌的患者接受了 CCRT。将 CCRT 的反应分为进展性疾病（PD）、稳定疾病（SD）、部分缓解（PR）或完全缓解（CR）。随后，研究了预测 CCRT 反应和患者生存的因素。
共有 535 例食管癌患者接受了 CCRT。493 例患者接受了随访，并对患者的结局进行了研究。在调整分析中，疾病分期较晚的患者（RR，III 期为 0.28，IV 期为 0.12，与 I 期相比）、体能状态较差、环形侵犯（RR，0.61）和男性（RR，0.31）较不易达到 CR。晚期疾病（HR，III/IV 期为 1.71）、CCRT 反应不良（HR，PR 为 2.82，SD 为 4.47，PD 为 4.77，与 CR 相比）和体能状态较差（HR，ECOG 2-4 为 1.38）被发现会增加死亡率。
晚期疾病、体能状态差、男性和环形侵犯是 CCRT 反应不良的独立预测因素。晚期疾病、体能状态差和 CCRT 反应不良是降低生存率的独立因素。
