Abstract

BackgroundWe conducted this study to combine the mean standardized uptake value (SUVmean) and neutrophil to lymphocyte ratio (NLR) to establish a strong predictive model for patients with esophageal squamous cell carcinoma (ESCC) after concurrent chemoradiotherapy (CCRT).MethodsWe retrospectively analyzed 163 newly diagnosed ESCC patients treated with CCRT. Eighty patients (training set) were randomly selected to generate cut-off SUVmean and NLR values by receiver operating characteristic (ROC) curve analysis and to establish a predictive model by using the independent predictors of treatment outcomes. Then, we evaluated the performance of the prediction model regarding treatment outcomes in the testing set (n = 83) and in all sets.ResultsA high SUVmean (> 5.81) and high NLR (> 2.42) at diagnosis were associated with unfavorable treatment outcomes in patients with ESCC. The prediction model had a better performance than the simple parameters (p < 0.05). With a cut-off value of 0.77, the prediction model significantly improved the specificity and positive predictive value for treatment response (88.9 and 92.1% in the training set, 95.8 and 97.1% in the testing set, and 92.2 and 91.8% in all sets, respectively).ConclusionsThe pretreatment SUVmean and NLR were independent predictors of treatment response in ESCC patients treated with CCRT. The predictive model was constructed based on these two parameters and provides a highly accurate tool for predicting patient outcomes.

Highlights

  • We conducted this study to combine the mean standardized uptake value (SUVmean) and neutrophil to lymphocyte ratio (NLR) to establish a strong predictive model for patients with esophageal squamous cell carcinoma (ESCC) after concurrent chemoradiotherapy (CCRT)

  • Patient characteristics A total of 163 newly diagnosed ESCC patients treated with CCRT were retrospectively analyzed, including 127 (77.9%) males and 36 (22.1%) females

  • Comparison of PET parameters We conducted a preliminary analysis of the predictive effect of PET parameters on predicting the treatment response of CCRT in esophageal cancer by performing a receiver operating characteristic (ROC) curve

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Summary

Introduction

We conducted this study to combine the mean standardized uptake value (SUVmean) and neutrophil to lymphocyte ratio (NLR) to establish a strong predictive model for patients with esophageal squamous cell carcinoma (ESCC) after concurrent chemoradiotherapy (CCRT). Concurrent chemoradiotherapy (CCRT) has been established as the standard treatment for locally advanced inoperable esophageal cancer (EC) patients, according to the phase III intergroup RTOG 85–01 trial [1]. According to data in the literature, the overall response rate (ORR) to CCRT in patients with esophageal cancer ranges from 53.3 to 98.3% [2,3,4]. We can improve this rate by setting individualized treatment strategies and intensities for different subgroups of patients. The early prediction of the tumor response before treatment may benefit this heterogeneous group of patients

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