Impact of Platelets to Lymphocytes Ratio and Lymphocytes during Radical Concurrent Radiotherapy and Chemotherapy on Patients with Nonmetastatic Esophageal Squamous Cell Carcinoma.

PURPOSE

This study examined the importance of hematological parameters as prognostic markers for people with esophageal cancer receiving radical concurrent chemoradiation.

METHODS

106 patients with esophageal cancer are included in this study. Cox regression analysis, Kaplan-Meier method, and chi-square test were used to analyze our data.

RESULTS

The median follow-up time for patients was 15.5 months (3-55). Univariate and multivariate analyses showed that age, the change of platelet-to-lymphocyte ratio (PLR), and the change rate of circulating lymphocyte count (CLC%) were independent influencing factors of OS and DFS. The patients were grouped according to the median of PLR and CLC%, and analysis showed that a higher PLR and a higher CLC% was related to poor OS and DFS ( < 0.001, < 0.001 and < 0.001, < 0.001). By subgroup analysis, the OS of T1-4N1-2 were better in the low PLR group than the high one ( = 0.03, < 0.001, = 0.001, < 0.001, and = 0.008). DFS of T3-4N1-2 in the low PLR group were better than the high one ( < 0.001, = 0.016 and < 0.001, = 0.022). For patients with T1-4N0-2, the OS in the low CLC% group were better than in the high CLC% group ( = 0.01, < 0.001, < 0.002, = 0.012, < 0.001, and = 0.024). For T1-4N1-2, the DFS were better in the low CLC% group than others ( = 0.042, < 0.001, < 0.001, < 0.001, and = 0.006).

CONCLUSION

PLR and CLC% are independent factors of OS and DFS, and a lower PLR and CLC% are associated with a better OS and DFS. And T3-4N1-2 patients in the low PLR group and low CLC% group have greater survival benefit.