Yuanliu Nie1, Guangyue Yao1, Liang Li2, Alei Feng3, Wentao Zhang4, Xiaoying Xu5, Qiang Li1,3, Zhe Yang1,3. 1. Tumor Research and Therapy Center, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, 250021, People's Republic of China. 2. Department of Thoracic Surgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, 250021, People's Republic of China. 3. Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People's Republic of China. 4. Shandong First Medical University, Jinan, Shandong, 250021, People's Republic of China. 5. Shandong First Medical University, College of Basic Medicine, Shandong First Medical University-Shandong Academy of Medical Sciences, Jinan, Shandong, 250000, People's Republic of China.
Abstract
Purpose: The present study assessed the effects of radiotherapy on overall survival (OS) and progression-free survival time (PFS) in patients with stage II or higher esophageal cancer receiving immunotherapy; evaluated factors independently prognostic of OS and PFS in these patients; and utilized these factors to establish a prognostic nomogram. Patients and Methods: This study enrolled 134 patients with stage II or higher esophageal cancer treated with chemotherapy (platinum-based agents plus paclitaxel or fluorouracil) and immunotherapy. These patients were divided into two groups, a radiotherapy (RT) group (n = 55) and a non-radiotherapy (non-RT) group (n = 79). Following 1:1 propensity score matching, OS and PFS were compared by the Kaplan-Meier method, and factors associated with survival were determined by univariate and multifactorial Cox regression analyses. These factors were used to construct a prognostic nomogram. Results: After propensity matching, all covariates were well balanced in the two groups (all P > 0.05). After matching, both median PFS (15.70 months [95% confidence interval (CI) 8.68-22.72 months] vs 5.70 months [95% CI 3.38-8.02 months], P = 0.002) and median OS (15.72 months [95% CI 12.94-18.46 months] vs 12.06 months [95% CI 9.91-14.20 months], P = 0.036) were significantly longer in the RT than in the non-RT group. Univariate and multifactorial analyses showed that RT, neutrophil-lymphocyte ratios, and tumor differentiation were independently prognostic of OS, with all hazard ratios (HRs) <1 and all P-values <0.05. A nomogram based on these factors was constructed, and its accuracy was verified. Conclusion: Immunotherapy plus RT resulted in better survival outcomes than immunotherapy alone. A nomogram based on prognostic factors can guide personalized treatment and monitor prognosis.
Purpose: The present study assessed the effects of radiotherapy on overall survival (OS) and progression-free survival time (PFS) in patients with stage II or higher esophageal cancer receiving immunotherapy; evaluated factors independently prognostic of OS and PFS in these patients; and utilized these factors to establish a prognostic nomogram. Patients and Methods: This study enrolled 134 patients with stage II or higher esophageal cancer treated with chemotherapy (platinum-based agents plus paclitaxel or fluorouracil) and immunotherapy. These patients were divided into two groups, a radiotherapy (RT) group (n = 55) and a non-radiotherapy (non-RT) group (n = 79). Following 1:1 propensity score matching, OS and PFS were compared by the Kaplan-Meier method, and factors associated with survival were determined by univariate and multifactorial Cox regression analyses. These factors were used to construct a prognostic nomogram. Results: After propensity matching, all covariates were well balanced in the two groups (all P > 0.05). After matching, both median PFS (15.70 months [95% confidence interval (CI) 8.68-22.72 months] vs 5.70 months [95% CI 3.38-8.02 months], P = 0.002) and median OS (15.72 months [95% CI 12.94-18.46 months] vs 12.06 months [95% CI 9.91-14.20 months], P = 0.036) were significantly longer in the RT than in the non-RT group. Univariate and multifactorial analyses showed that RT, neutrophil-lymphocyte ratios, and tumor differentiation were independently prognostic of OS, with all hazard ratios (HRs) <1 and all P-values <0.05. A nomogram based on these factors was constructed, and its accuracy was verified. Conclusion: Immunotherapy plus RT resulted in better survival outcomes than immunotherapy alone. A nomogram based on prognostic factors can guide personalized treatment and monitor prognosis.
Authors: Sun Young Kim; Min Joo Yoon; Young Iee Park; Mi Jung Kim; Byung-Ho Nam; Sook Ryun Park Journal: Gastric Cancer Date: 2017-08-21 Impact factor: 7.370
Authors: Jason J Luke; Jeffrey M Lemons; Theodore G Karrison; Sean P Pitroda; James M Melotek; Yuanyuan Zha; Hania A Al-Hallaq; Ainhoa Arina; Nikolai N Khodarev; Linda Janisch; Paul Chang; Jyoti D Patel; Gini F Fleming; John Moroney; Manish R Sharma; Julia R White; Mark J Ratain; Thomas F Gajewski; Ralph R Weichselbaum; Steven J Chmura Journal: J Clin Oncol Date: 2018-02-13 Impact factor: 44.544