Preliminary Establishment of a Scoring System Based on Medical History,Vital Signs,and Routine Blood Test for Prediction of the Prognosis of Esophageal Cancer / 中国医科大学学报

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.