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Tumor Remission and Tumor-Infiltrating Lymphocytes During Chemoradiation Therapy: Predictive and Prognostic Markers in Locally Advanced Esophageal Squamous Cell Carcinoma

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机构: [1]Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Key Lab Canc Prevent & Therapy, Dept Radiat Oncol,Tianjins Clin Res Ctr Canc, Tianjin, Peoples R China [2]Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Key Lab Canc Prevent & Therapy, Dept Pathol,Tianjins Clin Res Ctr Canc, Tianjin, Peoples R China [3]Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Key Lab Canc Prevent & Therapy, Dept Endoscopy Diag & Therapy,Tianjins Clin Res C, Tianjin, Peoples R China [4]Hebei Med Univ, Hosp 4, Dept Radiotherapy, Shijiazhuang, Hebei, Peoples R China [5]Tianjin Med Univ Canc Inst & Hosp, Dept Esophageal Canc, Tianjin, Peoples R China
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Purpose: Clinical tools are unavailable for accurate prediction of pathologic responses to chemoradiation therapy (CRT) among patients with esophageal squamous cell carcinoma (ESCC) before surgery. We evaluated tumor remission and tumor-infiltrating lymphocytes (TILs) during CRT as predictors of pathologic response and prognostic markers for patients with locally advanced ESCC treated with neoadjuvant CRT (neo-CRT) or definitive CRT. Methods and Materials: We analyzed patients with locally advanced ESCC (N = 164) who underwent neo-CRT (N = 48) or definitive CRT (N = 116). Patients underwent endoscopic ultrasonography and biopsies when induction CRT finished. Tumor remission characteristics were designated minor (-/+) to excellent remission (ER) (+++). TILs were determined in 10% increments. Tumor remission, TILs, or both were associated with pathologic complete response (pCR) and survival in the neo-CRT group and then analyzed in the definitive CRT group. Results: ER and lymphocyte-predominant ESCC (LPE; >= 60% TILs) were identified according to the pCR rate and disease-free survival. We built a prediction model for pCR incorporating ER and LPE. The area under the receiver operating characteristic curve was 0.877, and sensitivity and specificity were 86.7% and 90.9%, respectively. Furthermore, this model identified pathologic response with an excellent calibration. Disease-free survival of patients with ER and LPE tumors was significantly longer than that of other patients. Conclusions: When we included tumor remission and TILs during CRT, our model predicted pCR with high probability and helped stratify prognostic sub-groups, thereby guiding future therapy decisions for patients with locally advanced ESCC. Validation of this model in larger, prospective, multicenter studies is essential. (C) 2019 The Authors. Published by Elsevier Inc.

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出版当年[2019]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 核医学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 肿瘤学 2 区 核医学
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出版当年[2019]版:
Q1 ONCOLOGY Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版:
Q1 ONCOLOGY Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

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第一作者机构: [1]Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Key Lab Canc Prevent & Therapy, Dept Radiat Oncol,Tianjins Clin Res Ctr Canc, Tianjin, Peoples R China
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