Abstract
OBJECTIVES:Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors in China. Intensity-modulated radiation therapy and volume-modulated arc therapy have become the main treatments for esophageal carcinoma; however, side effects caused by radiotherapy greatly impact the quality of life in these patients. This study aimed to explore the impact of serum superoxide dismutase (SOD) levels on the prognosis of patients with ESCC undergoing radiotherapy.METHODS:Patients aged between 18 and 80 years with lower-middle ESCC who underwent radiotherapy were eligible for this assessment. Adverse events, responses, treatment outcomes, and overall survival (OS) were assessed. Between 2012 and 2014, 195 patients were enrolled, of which 65 were assigned to the low- and high-SOD groups based on their serum SOD values.RESULTS:The baseline characteristics were similar between the two groups, except for the T staging. Adverse events in the low-SOD group were significantly higher than those in the high-SOD group (radiation esophagitis, p=0.007; radiation pneumonitis, p=0.032; leukopenia, p=0.023; thrombocytopenia, p=0.037; anemia, p=0.041). There were no significant differences in response, treatment outcomes, or OS.CONCLUSION:In conclusion, high serum SOD activity improved post-radiotherapy quality of life but did not impact the prognosis of patients with ESCC. To the best of our knowledge, this study is the first to report that serum SOD activity is associated with radiation-induced toxicity and moderately increased radiotherapeutic response in patients with ESCC undergoing radiotherapy.
Highlights
Esophageal squamous cell carcinoma (ESCC) is a common malignancy of the digestive tract that poses a serious threat to human health
We evaluated the role of superoxide dismutase (SOD) expression on adverse events, responses, treatment outcomes, and overall survival (OS) of patients undergoing radiotherapy
The exclusion criteria were as follows: 1) cervical and upper thoracic esophageal cancer; 2) surgical treatment; 3) presence of distant metastasis; 4) presence of other organ dysfunction, such as insufficient pulmonary function, liver insufficiency, renal insufficiency, or myelosuppression; 5) history of radiotherapy or chemotherapy; 6) copper- or zinc-containing supplements taken before treatment, or other significant factors that interfere with the measurement if SOD including jaundice, lipids, and hemolysis; 7) only receiving chemotherapy without radiotherapy; 8) missing clinical information
Summary
Esophageal squamous cell carcinoma (ESCC) is a common malignancy of the digestive tract that poses a serious threat to human health. In 2018, there were approximately 570,000 new cases worldwide, and 500,000 people died of esophageal cancer. No potential conflict of interest was reported. Received for publication on August 6, 2020. Accepted for publication on December 2, 2020
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