| Guo Xinwei,Yang Rui,Sun Hongjuan,et al.Impact of pretreatment fibrinogen-to-prealbumin ratio and C-reactive protein-to-lymphocyte ratio on the efficacy and prognosis of thoracic esophageal squamous cell carcinoma treated with radiotherapy or chemoradiotherapy[J].Chinese Journal of Radiological Medicine and Protection,2026,46(3):256-263 |
| Impact of pretreatment fibrinogen-to-prealbumin ratio and C-reactive protein-to-lymphocyte ratio on the efficacy and prognosis of thoracic esophageal squamous cell carcinoma treated with radiotherapy or chemoradiotherapy |
| Received:February 23, 2025 |
| DOI：10.3760/cma.j.cn112271-20250223-00058 |
| KeyWords:Esophageal squamous cell carcinoma Fibrinogen-to-prealbumin ratio C-reactive protein-to-lymphocyte ratio Chemoradiotherapy Prognosis |
| FundProject:江苏卫生健康职业学院校级科研项目(JKCY202420);泰州市社会发展项目(SSF20230012) |
| Author Name | Affiliation | E-mail | | Guo Xinwei | Department of Radiation Oncology, Taixing People's Hospital, Affiliated Taixing People's Hospital of Yangzhou University, Taixing Clinical Hospital of Jiangsu Health Vocational College, Taixing 225400, China | | | Yang Rui | Department of Radiation Oncology, Taixing People's Hospital, Affiliated Taixing People's Hospital of Yangzhou University, Taixing Clinical Hospital of Jiangsu Health Vocational College, Taixing 225400, China | | | Sun Hongjuan | Department of Radiation Oncology, Taixing People's Hospital, Affiliated Taixing People's Hospital of Yangzhou University, Taixing Clinical Hospital of Jiangsu Health Vocational College, Taixing 225400, China | | | Zhou Shaobing | Department of Radiation Oncology, Taixing People's Hospital, Affiliated Taixing People's Hospital of Yangzhou University, Taixing Clinical Hospital of Jiangsu Health Vocational College, Taixing 225400, China | | | Liu Yangchen | Department of Radiation Oncology, Taixing People's Hospital, Affiliated Taixing People's Hospital of Yangzhou University, Taixing Clinical Hospital of Jiangsu Health Vocational College, Taixing 225400, China | liuyctx@163.com |
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| Abstract:: |
| Objective To investigate the impact of pretreatment fibrinogen-to-prealbumin ratio (FPR) and C-reactive protein-to-lymphocyte ratio (CLR) on treatment efficacy and survival prognosis in patients with thoracic esophageal squamous cell carcinoma (ESCC) undergoing radiotherapy or chemoradiotherapy. Methods A retrospective analysis was conducted on 150 patients with thoracic ESCC who received radical radiotherapy or chemoradiotherapy at Taixing People’s Hospital between January 2014 and December 2018. Based on the medians of pretreatment FPR and CLR, patients were divided into the FPR≥0.195 group (n = 76) and the FPR<0.195 group (n = 74), as well as the CLR≥4.294 group (n = 75) and the CLR<4.294 group (n = 75). Treatment efficacy was analyzed using logistic regression. Survival prognosis was assessed using progression-free survival (PFS) and overall survival (OS) calculated with the Kaplan-Meier method. The log-rank test and multivariate analysis with the Cox proportional hazards model were performed. Results The overall response rate for the entire cohort was 69.3%. In the CLR groups, the response rates were 49.3% in the CLR≥4.294 group and 89.3% in the CLR<4.294 group. In the FPR groups, the response rates were 52.6% in the FPR≥0.195 group and 86.5% in the FPR<0.195 group. Univariate logistic regression analysis showed that treatment efficacy was significantly associated with tumor location, T stage, N stage, TNM stage, treatment modality, FPR, and CLR [hazard ratio (HR) = 0.116-4.103, P<0.05]. Multivariate logistic regression analysis revealed that treatment modality, TNM stage, FPR, and CLR were independent risk factors for treatment efficacy (HR = 0.197-1.173, P<0.05). Univariate survival analysis indicated that tumor location, T stage, N stage, TNM stage, treatment modality, lymphocyte count, fibrinogen level, prealbumin level, C-reactive protein level, FPR, and CLR were significantly associated with PFS and OS (HRPFS = 0.564-3.646, P<0.05; HROS = 0.439-4.581, P<0.05). Multivariate Cox proportional hazards regression analysis demonstrated that TNM stage, treatment modality, FPR, and CLR were independent prognostic factors for both PFS (HR = 0.591-2.955, P<0.05) and OS (HR = 0.429-3.929, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for CLR and FPR was 0.810 and 0.720 for predicting treatment efficacy, 0.871 and 0.725 for predicting PFS, 0.871 and 0.752 for predicting OS, respectively, indicating that CLR had superior predictive value to FPR. Conclusions FPR and CLR are valuable predictors of short-term treatment efficacy and survival prognosis in patients with thoracic ESCC undergoing radiotherapy or chemoradiotherapy. |
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