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已发表论文
老年不可切除食管鳞状细胞癌患者接受放疗/放化疗的血液炎症评分比较及其预后价值
Authors Zhang Y, Wang J, Cui D, Kong L, Wang P, Fu Z, Lin L, Tang C, Liang J
Received 28 February 2025
Accepted for publication 25 September 2025
Published 14 October 2025 Volume 2025:18 Pages 14217—14230
DOI https://doi.org/10.2147/JIR.S525618
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Felix Marsh-Wakefield
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 China
Correspondence: 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 zhangyu_zhy@yeah.net
Objective: 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
Department of Oncology Center, Peking University International Hospital, Beijing, People’s Republic of China
Correspondence: 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 zhangyu_zhy@yeah.net
Objective: 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