PDF(Pubmed)
Abstract：
UNASSIGNED: The objectives of the present study are to perform a survival analysis of patients with thoracic esophageal squamous cell carcinoma (ESCC) receiving definitive radiotherapy and to identify prognostic factors from among the hematological and dosimetric factors.
UNASSIGNED: Cases of thoracic ESCC treated with radical RT between 2014 and 2017 were identified. The impact of clinicopathological factors on overall survival (OS) were analyzed using the Cox proportional hazards model. Absolute lymphocyte counts (ALC) and the neutrophil-to-lymphocyte ratio (NLR = ANC/ALC) were assessed before, during, and after radiotherapy (RT). Cox regression was used to correlate clinical factors with hematologic toxicities, dosimetric parameters and overall survival. Multiple logistic regression analysis was used to identify associations between lymphopenia and dosimetric parameters. With the overall survival status and real time events, the X-tile program was utilized to determine the optimal cut-off value of pretreatment NLR, and ALC nadir.
UNASSIGNED: Ninety-nine ESCC patients were enrolled in the present study. They had a median OS of 23 months. The median RT dose was 55.75Gy (46-66Gy), and the mean dose (Dmean) of the thoracic vertebrae (TVB) was 27.04±9.65Gy. Based on the multivariate analysis, the V20 of TVB, the pretreatment NLR, and the ALC nadir were associated with significantly worse OS. Concurrent CRT, which entailed increasing the mean TVB dose and V20 of TVB, was linked to a higher probability of lymphopenia risk (P<0.05). This was ascertained through the multiple logistic regression analysis.
UNASSIGNED: In ESCC patients who received definitive RT, V20 of TVB, pretreatment NLR, and ALC nadir during RT were independent prognostic factors and chemotherapy regimen, mean TVB dose, and V20 of TVB were associated with lymphopenia.
UNASSIGNED: Cases of thoracic ESCC treated with radical RT between 2014 and 2017 were identified. The impact of clinicopathological factors on overall survival (OS) were analyzed using the Cox proportional hazards model. Absolute lymphocyte counts (ALC) and the neutrophil-to-lymphocyte ratio (NLR = ANC/ALC) were assessed before, during, and after radiotherapy (RT). Cox regression was used to correlate clinical factors with hematologic toxicities, dosimetric parameters and overall survival. Multiple logistic regression analysis was used to identify associations between lymphopenia and dosimetric parameters. With the overall survival status and real time events, the X-tile program was utilized to determine the optimal cut-off value of pretreatment NLR, and ALC nadir.
UNASSIGNED: Ninety-nine ESCC patients were enrolled in the present study. They had a median OS of 23 months. The median RT dose was 55.75Gy (46-66Gy), and the mean dose (Dmean) of the thoracic vertebrae (TVB) was 27.04±9.65Gy. Based on the multivariate analysis, the V20 of TVB, the pretreatment NLR, and the ALC nadir were associated with significantly worse OS. Concurrent CRT, which entailed increasing the mean TVB dose and V20 of TVB, was linked to a higher probability of lymphopenia risk (P<0.05). This was ascertained through the multiple logistic regression analysis.
UNASSIGNED: In ESCC patients who received definitive RT, V20 of TVB, pretreatment NLR, and ALC nadir during RT were independent prognostic factors and chemotherapy regimen, mean TVB dose, and V20 of TVB were associated with lymphopenia.
摘要：
■本研究的目的是对接受确定性放疗的胸段食管鳞状细胞癌（ESCC）患者进行生存分析，并从血液学和剂量学因素中确定预后因素。
■确定了2014年至2017年接受根治性RT治疗的胸部ESCC病例。采用Cox比例风险模型分析临床病理因素对总生存期(OS)的影响。绝对淋巴细胞计数（ALC）和中性粒细胞与淋巴细胞比率（NLR=ANC/ALC）during,放疗后（RT）。Cox回归用于将临床因素与血液学毒性相关联，剂量学参数和总生存率。使用多元逻辑回归分析来确定淋巴细胞减少和剂量学参数之间的关联。总体生存状态和实时事件，X-tile程序用于确定预处理NLR的最佳截止值，和ALC最低点。
■本研究纳入了99例ESCC患者。他们的中位OS为23个月。中位RT剂量为55.75Gy（46-66Gy），胸椎（TVB）的平均剂量（Dmean）为27.04±9.65G。基于多变量分析，TVB的V20,预处理NLR，ALC最低点与OS显著恶化相关。并发CRT，这需要增加平均TVB剂量和TVB的V20，与淋巴细胞减少风险的可能性更高(P<0.05)。这是通过多元逻辑回归分析确定的。
■在接受明确RT的ESCC患者中，TVB的V20,预处理NLR,放疗期间ALC最低点是独立的预后因素和化疗方案，平均TVB剂量，TVB和V20与淋巴细胞减少有关。
■确定了2014年至2017年接受根治性RT治疗的胸部ESCC病例。采用Cox比例风险模型分析临床病理因素对总生存期(OS)的影响。绝对淋巴细胞计数（ALC）和中性粒细胞与淋巴细胞比率（NLR=ANC/ALC）during,放疗后（RT）。Cox回归用于将临床因素与血液学毒性相关联，剂量学参数和总生存率。使用多元逻辑回归分析来确定淋巴细胞减少和剂量学参数之间的关联。总体生存状态和实时事件，X-tile程序用于确定预处理NLR的最佳截止值，和ALC最低点。
■本研究纳入了99例ESCC患者。他们的中位OS为23个月。中位RT剂量为55.75Gy（46-66Gy），胸椎（TVB）的平均剂量（Dmean）为27.04±9.65G。基于多变量分析，TVB的V20,预处理NLR，ALC最低点与OS显著恶化相关。并发CRT，这需要增加平均TVB剂量和TVB的V20，与淋巴细胞减少风险的可能性更高(P<0.05)。这是通过多元逻辑回归分析确定的。
■在接受明确RT的ESCC患者中，TVB的V20,预处理NLR,放疗期间ALC最低点是独立的预后因素和化疗方案，平均TVB剂量，TVB和V20与淋巴细胞减少有关。
