Baseline FDG Uptake And Peripheral Lymphocyte-Monocyte Ratio For Predicting Chemoradiotherapy Response In Patients With Esophageal Squamous Cell Carcinoma
Received 15 August 2019
Accepted for publication 4 October 2019
Published 24 October 2019 Volume 2019:11 Pages 9085—9093
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Chien-Feng Li
Chunsheng Wang,1,* Kewei Zhao,2,* Yong Huang,3 Li Ma,3 Yipeng Song,2 Minghuan Li2
1Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai 264000, Shandong, People’s Republic of China; 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan 250117, Shandong, People’s Republic of China; 3Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong University, Jinan 250117, Shandong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Minghuan Li
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, 440 Jiyan Road, Jinan 250117, Shandong, People’s Republic of China
Tel +86 531 67626112
Fax +86 531 87984079
Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, 20 Yudong Road, Yantai 264000, Shandong, People’s Republic of China
Tel +86 0535 6691999
Fax +86 535 6240341
Purpose: To explore he predictive values of both the baseline SUVmax of 18F-fluorodeoxy-glucose by the primary tumor in positron emission tomography/computed tomography (PET/CT) and the lymphocyte-monocyte ratio (LMR) in peripheral blood in inoperable treated esophageal squamous cell carcinoma (ESCC) patients who received concurrent chemoradiotherapy (CCRT).
Patients and methods: Between January 2011 and December 2016, 138 newly diagnosed ESCC patients from our institution were retrospectively recruited. The optimal cut-off values for baseline SUVmax and peripheral LMR were determined by individual receiver operating characteristic curves. The predictive values of baseline SUVmax and peripheral LMR for primary tumor response were examined by chi-square and Fisher’s exact tests, as was their combined predictive value.
Results: The objective response rate (ORR) was significantly different between the high-SUVmax group and the low-SUVmax group (61.9% vs 87.8%; P=0.004), as well as between the high-LMR group and the low-LMR group (80.7% vs 52.0%; P=0.001). Furthermore, the low-SUVmax-high-LMR group achieved the best ORR (100%), which was significantly different from the ORRs of the high-SUVmax-high-LMR group (ORR: 72.1%, P=0.002), the high-SUVmax-low-LMR group (ORR: 45.7%, P=0.001), and the low-SUVmax-low-LMR group (ORR: 45.7%, P=0.001).
Conclusion: Baseline SUVmax of the primary tumor and the peripheral LMR are independent predictors of CCRT response in the primary tumors of ESCC patients. Patients who have lower FDG uptake accompanied by a higher peripheral LMR are more likely to have a better primary tumor response after CCRT.
Keywords: esophageal squamous cell carcinoma, maximum standardized uptake value, lymphocyte–monocyte ratio, chemoradiotherapy, tumor response
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