Changes Of Immune Function And Peripheral Blood Inflammation Indexes Effected On The Survival In Patients With Esophageal Squamous Cell Carcinoma Treated By Radiotherapy

Objective:The aim of this study is that to find simple and effective hematological immune indicators by checking a series of changes in peripheral blood cell count before,during,and at the end of treatment with radiotherapy,which can predict the long-term survival of patient with esophageal squamous cell carcinoma(ESCC)after radiotherapy.Methods:We retrospectively collected the clinical data of 82 patients with esophageal squamous cell carcinoma(ESCC).Peripheral blood immune function cells and various blood cells were checked and recorded before and after radiotherapy,and calculated the neutrophil-to-1ymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR),and systemic immune-inflammation index(SII).SPSS21.0 statistical software was used and,the changes of immune parameters before and after radiotherapy were analysed by t-test,Kaplan-Meier method was used to evaluate overall survival rate,progression-free survival rate,local control rate,and Log-rank testing for univariate analysis.Cox regression model for the multivariate analysis.Results:The follow-up of the whole group patients ended on October 20,2019,and 1 case was losted and the follow-up rate 98.8%.The 1-,3-,5-,and7-years overall survival rate of the 82 patients were 81.7%,33.5%,18.6%,16.1%,progression-free survival rates were 64.3%,23.5%,18.3%,14.2%,and the local control rates were 69.7%,32.1%,28.4%,26.4%,respectively.Univariate analysis showed ALC before and after radiotherapy,after radiotherapy NLR,MLR,SII and CD4/CD8 were significantly influencings factor for the overall survival(P<0.05).At the same time,found before and after radiotherapy ALC,after radiotherapy MLR,SII and CD4/CD8 were clearly factors for the progression-free survival(P<0.05),and after radiotherapy NLR affect on progression-free survival was close to a statistical difference(χ~2=3.783,P=0.052).Futher more,localregion control rate were affected by before and after radiotherapy ALC,before radiotherapy PLR,and after radiotherapy CD4/CD8,but the value of MLR after radiotherapy(χ~2=3.263,P=0.071)was closed to statistical difference for localregion control rate.Multivariate analysis showed that only the value of CD4/CD8 after radiotherapy was an independent influencing factor of overall survival,progression-free survival,and local control of esophageal squamous cell carcinoma treated by radiotherapy.Conclusions:1.The decreased extent of CD4/CD8 maybe predict the long-term sutvival in patients with esophageal squamous cell carcinoma treated by radiotherapy,and the value of CD4/CD8 was the higher,the long-term survival was the better.2.The long-term survival was greater with lower value of SII after radiotherapy,and the absolute value of ALC was also a indicating factor s,especially for the value of ALC after radiotherapy.3.This investigation results maybe inevitably interfered by the bias due to its retrospective quality and smaller patients from our single institution.