| Song Chunyang,Zhu Shuchai,Gao Sina,et al.Prognostic value of the geriatric nutritional risk index in elderly patients with esophageal squamous cell carcinoma receiving radical radiotherapy or radiochemotherapy[J].Chinese Journal of Radiological Medicine and Protection,2020,40(12):926-931 |
| Prognostic value of the geriatric nutritional risk index in elderly patients with esophageal squamous cell carcinoma receiving radical radiotherapy or radiochemotherapy |
| Received:April 01, 2020 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.12.006 |
| KeyWords:Esophageal squamous cell carcinoma (ESCC) Geriatric nutritional risk index (GNRI) Body mass index (BMI) Radiotherapy 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 | | Gao Sina | Department of Nephrology, Third Hospital of Shijiazhuang, Shijiazhuang 050011, China | | | Wang Xuan | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Cao Han | 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 | | | Li Shuguang | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Shen Wenbin | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | |
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| Abstract:: |
| Objective To evaluate the prognostic value of the Geriatric Nutritional Risk Index (GNRI) in elderly patients with esophageal squamous cell carcinoma (ESCC) accepting radical radiotherapy or radiochemotherapy. Methods Clinicopathological and laboratory data of 197 patients aged over 75 years old with ESCC who accepted radical radiotherapy or radiochemotherapy from January 2007 to December 2013 were retrospectively analyzed. GNRI and body mass index (BMI) were calculated and grouped. Univariate analysis was performed by Kaplan-Meier and multivariate analysis was performed by a Cox regression model. Results There were 139 patients in the normal GNRI group (GNRI>98) and 58 patients in the abnormal GNRI group (GNRI ≤ 98) before radiotherapy. The 5-year overall survival (OS) rates and progression-free survival (PFS) rates in the normal and abnormal GNRI groups were 11.08%, 9.82% and 8.73%, 6.18%, respectively, without statistically significant difference (P>0.05). There were 68 patients in the normal GNRI group and 129 patients in the abnormal GNRI group after radiotherapy. The 5-year OS rates and PFS rates in the normal and abnormal GNRI groups were 17.04%, 7.42% and 16.17%, 3.65%, respectively, with statistically significant difference (χ2=12.316, 14.617,P<0.05). Univariate analysis showed that T stage, N stage, TNM stage, GTV, NLR before radiotherapy, BMI after radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were significantly correlated with OS (χ2=6.569-22.434,P<0.05). And T stage, GTV, NLR before radiotherapy, BMI after radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were significantly correlated with PFS (χ2=4.579-18.990,P<0.05). Multivariate analysis showed that T stage, N stage, NLR before radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were independent factors for OS (P<0.05). And NLR before radiotherapy, hemoglobin level after radiotherapy and GNRI after radiotherapy were independent factors for PFS (P<0.05). Multivariate analysis showed that T stage, hemoglobin level after radiotherapy and GNRI after radiotherapy were independent factors for short-term effects (χ2=4.716, 13.083, 4.519, P<0.05). Conclusions The GNRI after radiotherapy can be used as a useful indicator for predicting survival in elderly patients with ESCC receiving radiotherapy or radiochemotherapy. Nutritional intervention should be carried out for elderly patients of abnormal GNRI with ESCC to improve survival. |
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