| Song Chunyang,Zhu Shuchai,Shen Wenbin,Gao Sina,Du Xingyu,Zhao Yan,Xu Jinrui.Analysis of the effects of immunity index and blood inflammatory markers pre- and post-radiotherapy on prognosis of clinical stage Ⅲ esophageal cancer patients[J].Chinese Journal of Radiological Medicine and Protection,2020,40(3):189-195 |
| Analysis of the effects of immunity index and blood inflammatory markers pre- and post-radiotherapy on prognosis of clinical stage Ⅲ esophageal cancer patients |
| Received:August 05, 2019 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.03.006 |
| KeyWords:Immune system Blood inflammatory markers Radiotherapy Esophageal cancer Prognosis |
| FundProject: |
| Author Name | Affiliation | E-mail | | Song Chunyang | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhu Shuchai | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | sczhu1965@163.com | | Shen Wenbin | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Gao Sina | Department of Nephrology, Third hospital of Shijiazhuang, Shijiazhuang 050011, China | | | Du Xingyu | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhao Yan | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Xu Jinrui | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | |
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| Abstract:: |
| Objective To study the effects of immunity index and blood inflammatory markers pre- and post-radiotherapy on prognosis of esophageal cancer patients with clinical stage Ⅲ. Methods A total of 84 esophageal cancer patients with clinical stage Ⅲ (T\-4N\-1M\-0) in Fourth Hospital of Hebei Medical University were analyzed, from May 2010 to April 2012. Intensity-modulated radiotherapy was delivered with a dose of 56-66 Gy/1.8-2.0 Gy per fraction. Flow cytometry was used to analyze the distribution of T-lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) and natural killer cells (CD56) in the peripheral blood pre- and post-radiotherapy. Neutrophil-lymphocyte ratio (NLR) pre- and post-radiotherapy were also tested. The correlation of immunity index and blood inflammatory markers with prognosis was analyzed by univariate and multivariate analysis. Results For all patients, the 1-, 3- and 5-year overall survival (OS) rates were 78.57%, 34.52% and 19.59%, respectively. The median OS time was 22.60 months. The 1-, 3- and 5-year progression free survival (PFS) rates were 69.05%, 27.38% and 12.09%, respectively. The median PFS time was 21.20 months. The objective response rate was 61.90%, with 11 patients of complete remission (CR) and 41 patients of partial remission (PR). Univariate analysis revealed that NLR before radiotherapy, T-lymphocyte subsets (CD3,CD4 and CD4/CD8) after radiotherapy were significantly associated with OS and PFS (OS:χ2=7.851, 4.443, 8.381, 5.972,P<0.05, PFS:χ2=7.475, 6.290, 9.659, 8.738, P<0.05). Multivariate COX regression analysis showed that NLR before radiotherapy, T-lymphocyte subsets (CD4, CD4/CD8) after radiotherapy were independent prognostic factors for OS (χ2=10.464, 4.292, 5.507, P<0.05). The NLR before radiotherapy and CD4/CD8 after radiotherapy were independent prognostic factors for PFS (χ2=10.835, 8.545, P<0.05). Conclusions Radiotherapy may influence the immune function. NLR before radiotherapy and CD4/CD8 after radiotherapy are of great value in predicting the prognosis of esophageal cancer patients. |
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