The Relationship Between The Efficacy Of The First-line Chemotherapy And The Serum Level Of Low Density Lipoprotein Cholestrol In Advanced Esophageal Squamous Cell Carcinoma

ObjectiveTo analyze the relevance of pre-chemotherapeutic serum low density lipoprotein cholesterol(LDL-C)levels and objective response rate(ORR),disease control rate(DCR)and progression free survival(PFS)in advanced esophageal squamous cell carcinoma(ESCC)with the first-line chemotherapy.To discuss the effect of LDL-C on the efficacy of chemotherapy and PFS in advanced ESCC.Material and MethodsThe 64 cases were all from department of oncology of the First Affiliated Hospital of Zhengzhou University during January 2012 to December 2015,which were histopathologically diagnosed as esophageal squamous cell carcinoma and of which clinical stage were IV.The received first-line chemotherapy regimen of all patients were cisplatin in combination with fluorouracil.This study is a retrospective study.The serum levels of LDL-C before chemotherapy,age,sex,BMI,ECOG PS score,depth of tumor invasion,lymph node metastasis or not,start time of chemotherapy and time of tumor progression were measured.Based on the upper limit of normal LDL-C level tested in the unit,the patients are divided into two groups:1)normal group: LDL-C<3.61mmol/L;2)high group: LDL-C?3.61mmol/L.In accordance with the WHO Response Evaluation Criteria in Solid Tumors 1.1(RECIST 1.1),the efficacy of all patients can be uniformly evaluated,until the patient with tumor progression or death.SPSS 20 statistical software was used to analyze the data.The count data is expressed as a percentage,and the measurement data is described by the mean or median.The difference between the two groups of clinical features and therapeutic efficacy is analyzed with ?~2 test,the survival curve is drawn by Kaplan-Meier method,and the difference of PFS between the two groups is contrasted by Log-rank.All tests were two-sided tests,P<0.05 for the difference was statistically significant.Results 1.The clinical pathological features of the different LDL-C levels patientsThere are 36 patients in normal LDL-C group,28 patients in higher LDL-C group,the difference of clinical pathological characteristics in two group has no statistical significance(P > 0.05).The serum LDL-C levels have no correlation with age,gender,BMI,ECOG PS score,depth of tumor invasion,lymph node metastasis or not.2.The relevance of serum LDL-C levels and ORR,DCRThe efficacy of 64 patients without loss of follow-up and death can be evaluated after chemotherapy.3 cases are complete remission(CR)and response rate is 4.7%,16 cases are partial remission(PR)and response rate is 25.0%,11 cases are stable disease(SD)and response rate is 17.2%,34 cases are disease progression(PD)and response rate is 53.1%.ORR is 29.7%,DCR is 46.9%.In the normal LDL-C group,2 cases are CR and response rate is 5.5%,12 cases are PR and response rate is 33.3%,7 cases are SD and response rate is 19.4%,15 cases are PD and response rate is 41.8%.In the high LDL-C group,1 cases are CR and response rate is 3.6%,4 cases are PR and response rate is 14.3%,4 cases are SD and response rate is 14.3%,19 cases are PD and response rate is 67.8%.ORR of the normal LDL-C group is 38.8%,this of the high LDL-C group is 17.9%,there is no statistically significant of the difference of ORR between the two groups(P=0.068);DCR of the normal LDL-C group is 58.2%,this of the high LDL-C group is 32.2%,the difference of DCR was statistically significant between the two groups(P=0.037).Compared with patients with elevated LDL-C level,patients with normal LDL-C level have better DCR,and ORR of them has a increasing trend.3.The relevance of serum LDL-C levels and PFSThe median PFS of the the normal LDL-C group is 9 months(95%CI:8.1~ 9.9),and this of the high LDL-C group is 7 months(95%CI:5.6 ~ 8.4).The difference of PFS between the two groups was statistically significant(?~2=12.388,P<0.001);The difference of PFS between other factors has no statistical significant(P > 0.05).Compared with patients with elevated LDL-C level,patients with normal LDL-C level have longer PFS.Conclusions 1.Normal serum level of LDL-C is associated with better curative effect and longer PFS in advanced ESCC patients treated with the first-line chemotherapy,which are more likely to make those patients benefit from the first-line chemotherapy.2.LDL-C may be a potential predictor of chemotherapy efficacy of advanced ESCC patients.