We initial aimed to investigate pre/post-treatment inflammatory biomarkers (pre/post-IBs) and their dynamic changes (delta-IBs) on short-term effect (STE). Furthermore, a nomogram was built to provide accurate prediction of STE in patients with esophageal squamous cell carcinoma (ESCC) who received radiotherapy.
The IBs included absolute lymphocyte counts (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR). All pre/post-IBs and delta-IBs of 398 ESCC patients at Shandong Cancer Hospital between 2015 and 2019 were analyzed. The nomogram was then constructed that forecasted STE based on logistic regression analyses.
At 1 month after radiotherapy, 261 patients (65.6%) achieved remission, and 137 patients (34.4%) achieved un-remission. The pre-ALC and pre-LMR significantly increased, pre-NLR and pre-PLR significantly decreased during radiotherapy (all P<0.001). Meanwhile, there was a positive correlation between delta-NLR as well as delta-PLR and delta-LMR (r=0.621 and 0.613, respectively), whereas a negatively correlated between delta-LMR and delta-PLR (r=-0.573). Multivariate analysis indicated that gender [OR, 0.473; 95%CI, 0.274-0.816; P=0.007], pre-ALC [OR, 0.554; 95%CI, 0.335-0.915; P=0.021], pre-NLR [OR, 3.176; 95%CI, 1.733-5.823; P<0.001], post-NLR [OR, 2.418; 95%CI, 1.271-4.600; P=0.007] and delta-NLR [OR, 1.929; 95%CI, 1.035-3.595; P=0.039] were statistically significant with STE. Nomogram for STE was established by combining all independent predictors and the concordance indexes for STE were 0.770 [95%CI, 0.719–0.820].
In conclusion, pre-NLR and pre-ALC, post-NLR, and delta-NLR could predict STE in ESCC patients. Further, pre-NLR had the best predictive value, and the developed nomogram with superior prediction ability for STE could assist in patients counseling and guide to make treatment decisions.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jiyan Road 440, Jinan 250117, Shandong, People’s Republic of China.
This work was supported by the National Natural Science Foundation of China (81972864), Academic Promotion Program of Shandong First Medical University (2019RC002), Science and Technology Support Plan for Youth Innovation Teams of Universities in Shandong Province (2019KJL001) and Science and Technology Plan of Jinan (201907113).
All authors have declared no conflicts of interest.