Comparison of Blood Inflammation Scores and Their Prognostic Value in Elderly Unresectable Esophageal Squamous Cell Carcinoma Patients Treated with Radiotherapy/Chemoradiotherapy
Year: 2025
Type: article
Abstract: Yu Zhang, Jidong Wang, Di Cui, Lei Kong, Peng Wang, Zhixue Fu, Li Lin, Chuanhao Tang, Jun Liang Department of Oncology Center, Peking University International Hospital, Beijing, People’s Republic of ChinaCorrespondence: Yu Zhang, Department of Oncology Center, Peking University International Hospital, No.1 of Life Park Road, Life Science Park of Zhong Guancun, Changping District, Beijing, 102206, People’s Republic of China, Email [email protected]: To investigate the predictive value of inflammation-based prognostic scores (IBs) on overall survival (OS) in elderly unresectable esophageal squamous cell carcinoma (ESCC) patients treated with radiotherapy (RT) or chemoradiotherapy (CRT).Methods: This retrospective study included 120 elderly ESCC patients who received RT/CRT. IBs, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and systemic immune response index (SIRI), were calculated within one week before treatment and within two weeks after treatment.Results: A total of 120 patients were included. The median age was 76 years. Significant differences were found between survivors (n=29) and non-survivors (n=91) in tumor size (p=0.018), T stage (p=0.006), and pre-treatment lymphocyte count (p=0.002). At the study endpoint, 75.8% of patients (91/120) had died, and 24.2% (29/120) remained alive. The median overall survival (OS) and progression-free survival (PFS) were 18 months and 15 months, respectively. The 1-year, 3-year, and 5-year OS rates were 61.7%, 18.3%, and 5.8%, respectively, and the corresponding PFS rates were 40.8%, 7.5%, and 1.7%. Pre-treatment NLR, SIRI, and SII were associated with OS. Post-treatment NLR and PLR were also predictors. However, in multivariate analysis, only age (p=0.002) and adverse events (p=0.003) remained independent predictors of OS.Conclusion: High NLR, SII, and SIRI before treatment, and NLR and PLR after treatment, were associated with poorer OS in elderly ESCC patients undergoing RT/CRT. However, none of these IBs remained independent predictors in multivariate analysis, suggesting that their prognostic value may be influenced by confounding factors.Keywords: esophageal squamous cell carcinoma, chemoradiotherapy, prognostic biomarkers, inflammation, elderly patients
Authors: Zhang Y, Wang J, Cui D, Kong L, Wang P, Fu Z, Lin L, Tang C, Liang J
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7092115258
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