苏格兰炎症预后评分与接受新辅助免疫化疗的食管癌患者治疗相关不良事件和预后的关系。
Association of the Scottish inflammatory prognostic score with treatment-related adverse events and prognosis in esophageal cancer receiving neoadjuvant immunochemotherapy.
机构信息
Department of Thoracic Oncological Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus) of Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, China.
出版信息
Front Immunol. 2024 Jul 5;15:1418286. doi: 10.3389/fimmu.2024.1418286. eCollection 2024.
BACKGROUND
To investigate the relationship between the Scottish inflammatory prognostic score (SIPS), treatment-related adverse events (TRAEs), and prognostication in patients with neoadjuvant immunochemotherapy (NICT) for esophageal squamous cell carcinoma (ESCC).
METHODS
A retrospective investigation was carried out on 208 ESCC patients treated with NICT. The relationships between the SIPS, TRAEs, and prognosis [disease-free survival (DFS) and overall survival (OS)] were analyzed.
RESULTS
The patients, comprising 62 (29.8%) cases of SIPS0, 103 (49.5%) cases of SIPS1, and 43 (20.7%) cases of SIPS2, were categorized into three groups based on SIPS. Among patients with SIPS2, the oldest age (P=0.006), lowest BMI (P=0.001), longest tumor length (P=0.001), most advanced ypT stage (P=0.014), and ypN stage (P<0.001) were identified. Pathological complete response (PCR) rates showed statistically significant variations between the three groups (SIPS0: 45.2%, SIPS1: 27.2%, SIPS2: 16.3%, P=0.004). All TRAEs were found in 63.9% (133 cases) of the cases, with serious TRAEs (grade 3-4) accounting for 13.9% (29 cases). TRAEs themselves were not linked with SIPS (P=0.668), while serious TRAEs had a significant correlation with SIPS (P=0.002). Multivariate logistic analysis showed that SIPS2 seemed to confer serious TRAEs [odds radio (OR)=4.044; 95% CI: 1.395-11.722; P=0.010]. For patients classified as SIPS0, 1, or 2, the 3-year DFS was 83.9%, 58.3%, and 39.5% (P<0.001). The 3-year OS for those with SIPS0, 1, or 2 was 88.7%, 72.8%, and 53.5%, respectively (P<0.001). SIPS was substantially correlated with DFS (but not with OS) and could be utilized as an independent predictor [SIPS2: hazard ratio (HR)=3.743, 95% CI: 1.770-7.914, P=0.001; SIPS1: HR=2.303, 95% CI: 1.149-4.616, P=0.019].
CONCLUSION
The SIPS is associated with serious TRAEs and can be used as a predictor of serious TRAEs in ESCC receiving NICT. SIPS may be employed for pretreatment assessment since it was found to be substantially correlated with DFS.
背景
为了探究苏格兰炎症预后评分（SIPS）与治疗相关不良事件（TRAEs）以及新辅助免疫化疗（NICT）治疗食管鳞状细胞癌（ESCC）患者预后（无病生存（DFS）和总生存（OS））之间的关系。
方法
对 208 例接受 NICT 治疗的 ESCC 患者进行回顾性调查。分析了 SIPS、TRAEs 与预后（DFS 和 OS）之间的关系。
结果
根据 SIPS，患者分为三组：SIPS0 组 62 例（29.8%）、SIPS1 组 103 例（49.5%）和 SIPS2 组 43 例（20.7%）。SIPS2 组患者年龄最大（P=0.006）、BMI 最低（P=0.001）、肿瘤最长（P=0.001）、ypT 分期最晚期（P=0.014）和 ypN 分期最晚期（P<0.001）。三组间病理完全缓解（PCR）率存在统计学差异（SIPS0：45.2%，SIPS1：27.2%，SIPS2：16.3%，P=0.004）。63.9%（133 例）的患者发生了所有 TRAEs，其中 13.9%（29 例）为严重 TRAEs（3-4 级）。TRAEs 本身与 SIPS 无关（P=0.668），而严重 TRAEs 与 SIPS 显著相关（P=0.002）。多因素 logistic 分析显示，SIPS2 似乎与严重 TRAEs 相关（OR=4.044；95%CI：1.395-11.722；P=0.010）。SIPS0、1 和 2 组患者的 3 年 DFS 分别为 83.9%、58.3%和 39.5%（P<0.001）。SIPS0、1 和 2 组患者的 3 年 OS 分别为 88.7%、72.8%和 53.5%（P<0.001）。SIPS 与 DFS 显著相关（但与 OS 无关），可作为独立的预后预测因子[SIPS2：HR=3.743，95%CI：1.770-7.914，P=0.001；SIPS1：HR=2.303，95%CI：1.149-4.616，P=0.019]。
结论
SIPS 与严重 TRAEs 相关，可作为 ESCC 接受 NICT 治疗患者发生严重 TRAEs 的预测因子。SIPS 可能在新辅助免疫化疗前用于评估，因为它与 DFS 有显著相关性。
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