Article Abstract

Dysphagia predict the response to second cycle neoadjuvant chemotherapy in first cycle no response esophageal carcinoma

Authors: Yan Zheng, Yin Li, Jianjun Qin, Wenqun Xing, Xianben Liu, Haibo Sun, Xiankai Chen


Background: After the first-cycle of neoadjuvant chemotherapy (NAC), many patients with esophageal squamous cell carcinoma (ESCC) experience a stable disease (SD)/progressive disease (PD) response. Clinically, SD patients are recommended to receive a second cycle of NAC, and PD patients are recommended to undergo surgery if possible. However, we found some PD tumors shrank after a second-cycle of NAC. Some first-cycle SD patients may develop PD after second-cycle NAC and lose the chance of surgery. Thus, how to predict the response to second-cycle NAC for first-cycle SD/PD patients is important for clinical practice.
Methods: This retrospective single-center study was approved by the Institutional Review Board at the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital. We retrospectively reviewed patients with ESCC who had NAC and evaluated SD by computed tomography (CT) scan after the first-cycle between March 9, 2013 and October 24, 2016. Univariate and multivariate analyses of the clinical parameters were performed to identify markers predictive of a clinically response by using IBM-SPSS version 23.
Results: There were 64 patients included in the study. Thirty-one first-cycle NAC-SD/PD patients (48.4%) showed a response after second-cycle NAC, which was significantly correlated with alleviated dysphagia (P=0.006) and smoking (P=0.025). In the multivariate analyses, alleviated dysphagia [odds ratio (OR) 3.978; 95% confidence interval (CI), 1.335–11.856; P=0.013] was identified as the only independent predictive factor for tumor response after second-cycle of NAC for first-cycle SD/PD patients.
Conclusions: Alleviated dysphagia might be a useful factor to predict the response to second-cycle NAC for first-cycle SD/PD patients.