Clinical Factors to Predict the Response to Concurrent Chemoradiotherapy and Survival in Esophageal Cancer Patients
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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. Methods: 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. Results: 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. Conclusions: 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.
Abstract
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. Methods: 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. Results: 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. Conclusions: 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.
참고문헌 (24)
- Bray F, "Global cancer statistics 2018 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries", CA Cancer J Clin, 68, pp.394~424 (2018)
- Pickens A, "Geographical distribution and racial disparity in esophageal cancer", Ann Thorac Surg, 76, pp.S1367~S1369 (2003)
- Siegel RL, "Cancer statistics, 2016", CA Cancer J Clin, 66, pp.7~30 (2016)
- al-Sarraf M, "Progress report of combined chemoradiotherapy versus radiotherapy alone in patients with esophageal cancer : an intergroup study", J Clin Oncol, 15, pp.277~284 (1997)
- Amini A, "Factors associated with local-regional failure after definitive chemoradiation for locally advanced esophageal cancer", Ann Surg Oncol, 21, pp.306~314 (2014)
- Nomura M, "Recursive partitioning analysis for new classification of patients with esophageal cancer treated by chemoradiotherapy", Int J Radiat Oncol Biol Phys, 84, pp.786~792 (2012)
- Chao YK, "Using pretreatment tumor depth and length to select esophageal squamous cell carcinoma patients for nonoperative treatment after neoadjuvant chemoradiotherapy", Ann Surg Oncol, 20, pp.3000~3008 (2013)
- Bedenne L, "Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus : FFCD 9102", J Clin Oncol, 25, pp.1160~1168 (2007)
- Stahl M, "Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus", J Clin Oncol, 23, pp.2310~2317 (2005)
- Ishida K, "Phase II study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus : a Japan Esophageal Oncology Group(JEOG)", Japan Clinical Oncology Group trial(JCOG9516), 2004, pp.34, 615~619
- Kato K, "Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for stage II-III esophageal squamous cell carcinoma : JCOG trial(JCOG 9906)", Int J Radiat Oncol Biol Phys, 81, pp.684~690 (2011)
- Kimura J, "Evaluation of the Glasgow Prognostic Score in patients receiving chemoradiotherapy for stage III and IV esophageal cancer", Dis Esophagus, 29, pp.1071~1080 (2016)
- Di Fiore F, "Predictive factors of survival in patients treated with definitive chemoradiotherapy for squamous cell esophageal carcinoma", World J Gastroenterol, 12, pp.4185~4190 (2006)
- Zhu LL, "A meta-analysis of concurrent chemoradiotherapy for advanced esophageal cancer", PLoS One, 10, pp.e0128616~ (2015)
- Yang YS, "Esophageal luminal stenosis is an independent prognostic factor in esophageal squamous cell carcinoma", Oncotarget, 8, pp.43397~43405 (2017)
- Ajani JA, "ALDH-1 expression levels predict response or resistance to preoperative chemoradiation in resectable esophageal cancer patients", Mol Oncol, 8, pp.142~149 (2014)
- Izzo JG, "Association of activated transcription factor nuclear factor kappab with chemoradiation resistance and poor outcome in esophageal carcinoma", J Clin Oncol, 24, pp.748~754 (2006)
- Makino T, "p53 mutation status predicts pathological response to chemoradiotherapy in locally advanced esophageal cancer", Ann Surg Oncol, 17, pp.804~811 (2010)
- Gao Y, "BRCA1 mRNA expression as a predictive and prognostic marker in advanced esophageal squamous cell carcinoma treated with cisplatin-or docetaxel-based chemotherapy", chemoradiotherapy, 2013, pp.8, e52589~
- Brabender J, "ERCC1 RNA expression in peripheral blood predicts minor histopathological response to neoadjuvant radio-chemotherapy in patients with locally advanced cancer of the esophagus", J Gastrointest Surg, 12, pp.1815~1821 (2008)
- Duong C, "Pretreatment gene expression profiles can be used to predict response to neoadjuvant chemoradiotherapy in esophageal cancer", Ann Surg Oncol, 14, pp.3602~3609 (2007)
- Wen J, "Gene expression analysis of pretreatment biopsies predicts the pathological response of esophageal squamous cell carcinomas to neo-chemoradiotherapy", Ann Oncol, 25, pp.1769~1774 (2014)
- Wen J, "MiRNA expression analysis of pretreatment biopsies predicts the pathological response of esophageal squamous cell carcinomas to neoadjuvant chemoradiotherapy", Ann Surg, 263, pp.942~948 (2016)
- Skinner HD, "A validated miRNA profile predicts response to therapy in esophageal adenocarcinoma", Cancer, 120, pp.3635~3641 (2014)