治疗前Naples预后评分对胸段食管鳞癌患者放化疗疗效及预后的影响

目的:探讨治疗前Naples预后评分(NPS)对胸段食管鳞癌接受放化疗患者治疗效果及生存预后的影响。方法:回顾性分析2014年1月至2017年12月在扬州大学附属泰兴人民医院行根治性放疗或放化疗的123例胸段食管鳞癌患者，根据治疗前NPS评分分为0分组(18例)、1或2分组(60例)、3或4分组(45例)。治疗效果采用...

Effects of pre-treatment Naples prognostic score on the efficacy and prognosis for patients with thoracic esophageal squamous cell carcinoma receiving chemoradiotherapy

Objective To investigate the effects of pre-treatment Naples prognostic score (NPS), including inflammation-related and nutrition-related indicators, on the treatment efficacy and prognosis of patients with thoracic esophageal squamous cell carcinoma (ESCC) receiving chemoradiotherapy.Methods A retrospective analysis was conducted for 123 patients diagnosed with thoracic ESCC. These patients were treated either with standard curative radiotherapy (RT) alone or with concurrent chemoradiotherapy (CCRT) in the Affiliated Taixing People''s Hospital of Yangzhou University between January 2014 and December 2017. The patients were divided into NPS 0 group (18 cases), NPS 1 or 2 group (60 cases), and NPS 3 or 4 group (45 cases). The responsiveness to treatment was analyzed using logistic regression analysis. The Kaplan-Meier method and log-rank test were adopted to calculate and compare the progression-free survival (PFS) and overall survival (OS) rates. Meanwhile, Cox proportional hazards models were used for the multivariate analyses.Results The overall effective rate across the entire cohort was 65.0%, and the effective rates of the NPS 0 group, NPS 1 or 2 group, and NPS 3 or 4 group were 88.9%, 73.3%, and 44.4%, respectively. As indicated by the univariate logistic analysis, the treatment responses in patients with ESCC were highly associated with TNM stage, treatment method, neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and NPS (1 or 2 group and 3 or 4 group) (HR=1.633, 0.225, 4.002, 0.320, 2.909, 6.591, P < 0.05). Subsequently, multivariate logistic regression analysis showed that treatment strategy alone (HR=0.214, 95% CI 0.105-0.436, P=0.001), NLR (HR=2.547, 95% CI 1.248-5.199, P=0.010), and NPS (1 or 2 group:HR=1.193, 95% CI 1.377-9.691, P=0.033; 3 or 4 group:HR=3.349, 95% CI 1.548-10.499, P=0.003) were independent risk factors for tumour response. In addition, the univariate analysis indicates that TNM stage, treatment modality, NLR, LMR, and NPS were significantly associated with PFS and OS(HR_PFS=1.480, 0.364, 2.129, 0.635, 3.316, 6.599, P < 0.05; HR_OS=1.149, 0.308, 2.306, 0.609, 3.316, 6.599, P < 0.05). Furthermore, multivariate Cox proportional hazard regression model analysis showed that TNM stage (HR=1.408, 95% CI 1.069-1.854, P=0.015), treatment modality (HR=0.367, 95% CI 0.261-0.516, P=0.015), NLR (HR=1.518, 95% CI 1.078-2.139, P=0.017), and NPS (1 or 2 group:HR=3.279, 95% CI 1.405-7.653, P=0.006; 3 or 4 group:HR=6.233, 95% CI 2.439-15.875, P < 0.001) were considered independent prognostic factors for PFS. Additionally, these parameters were also independent prognostic factors for OS.Conclusions Using inflammation-related and nutrition-related biomarkers, this study demonstrated that NPS is promising as a predictive indicator for the therapeutic effects and survival prognosis in patients with ESCC receiving CRT or RT alone.