ABSTRACT
Objective To screen predictors for the prognosis of patients with inoperable locally advanced esophageal squamous carcinoma (LAESC) who are undergoing concurrent radiochemotherapy and establish a preliminary scoring system. Methods The data of 75 patients with inoperable LAESC who were undergoing intensity-modulated radiation therapy and concurrent chemotherapy were collected and analyzed to determine whether the prognosis was associated with medical history,vital signs,and the results of routine blood test and liver and kidney functions test before and at the end of radiochemotherapy. The prediction efficacy of the model was assessed using the receiver-operating characteristic curve. The degree of fitting was tested using the Hosmer-Lemeshow goodness-of-fit test. Results Seventy-five patients with LAESC were included. The univariate analysis indicated that the prognosis of the patients with LAESC who were undergoing concurrent radiochemotherapy was associated with weight loss of more than 5％,poor dietary habit,and significant decrease in white blood cell count (P = 0.047,0.074,and 0.074). The multivariate Cox model was conducted,and a scoring system for prediction of prognosis was established. The scores were 1.5 for weight loss of more than 5％,1.0 for poor dietary habit,and 1.0 for a significant decrease in white blood cell count (more than 2.0×109/L). A total score of more than 2.25 indicated a high mortality risk,with a sensitivity of 0.559 and a specificity of 0.805. Conclusion The simple and practical scoring system for prediction of prognosis of patients with LAESC in this study could generally predict the mortality risk of patients with inoperable LAESC who are undergoing concurrent radiochemotherapy.
ABSTRACT
ObjectiveTo investigate prognostic factors in Stage Ⅲ non-small cell lung cancer (NSCLC)treated with definitive radiation therapy (RT) with PET-CT-based radiotherapy planning. MethodsFifty nine patients with Stage Ⅲ NSCLC treated with radiation therapy of 60 Gy or more were enrolled into this study.The impact of prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The following-up rate was 98％.Nineteen patients completed 2 years' followed-up. The overall l-year and 2-year survival rate was 66％ and 37％, respectively, with a median survival time of 17 months. At a univariate analysis, cigarette smoking status, T stage, radiation dose, the standardized uptake value, the gross tumor volume and clinical stage were significant prognostic factors ( x2 =7.46,7. 52,8.37,4. 97,5.82,4. 37, P =0. 006,0. 006,0. 004,0. 026,0. 016,0. 037, respectively ).At multivariate analyses, cigarette smoking status, radiation dose, gross tumor volume and clinical stage were significant prognostic factors ( x2 =6. 20, 9. 69, 6. 39, 10. 09, P =0. 013,0. 002, 0. 011,0. 001,respectively). Conclusions Cigarette smoking status, radiation dose, gross tumor volume and clinical stage are significant prognostic factors on survival in patients with Stage Ⅲ NSCLC treated with RT based on PET-CT radiotherapy planning.
ABSTRACT
Objective To evaluate the prognostic value of fluorodeoxyglucose (FDG) standardized uptake value (SUV) of positron emission tomography (PET) before radiotherapy in non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT). Methods Seventy-three patients with stage Ⅲ NSCLC underwent PET to calculate SUV within 2 weeks before 3DCRT. The a-nalysis was carried out after the irradiation of 60 -66 Gy. The possible prognostic factors were assessed by Cox proportional hazards model. Results The mean SUV for squamous cell carcinoma, adenocarcinoma and others were 16.94, 14.40 and 6.33, respectively (F = 0. 51, P = 0. 604). The mean SUV for tumor volume less than and more than 50 cm~3 was 13.81 and 20.18 (F = 7.54, P = 0. 008). In the univariate analysis, a cutoff SUV of 17 and chemotherapy were correlated with the prognosis. In the multivariate analysis, SUV was the only independent prognostic factor (relative risk = 2.61). Conclusions SUV is a prognostic factor in patients with NSCLC treated by 3DCRT, which deserves further studies.