Pretreatment nutritional risk scores and performance status are prognostic factors in esophageal cancer patients treated with definitive chemoradiotherapy

// Tao Song 1, * , Qiuyan Wan 2, * , Wenke Yu 3 , Jianbo Li 4 , Shaohua Lu 5 , Chen Xie 6 , Hongqing Wang 7 and Min Fang 1 1 Department of Radiation Oncology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310000, Zhejiang, P.R. China 2 Department of Gynecologic Oncology, Jiangxi Cancer Hospital, Nanchang 330029, Jiangxi, P.R. China 3 Department of Radiology, Zhejiang Qingchun Hospital, Medical College of Zhejiang University, Hangzhou 310000, Zhejiang, P.R. China 4 Department of Radiation Oncology, Ningbo Mingzhou Hospital, Ningbo 315000, Zhejiang, P.R. China 5 Department of Radiation Oncology, Jinhua Guangfu Hospital, Jinhua 321000, Zhejiang, P.R. China 6 Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang 330029, Jiangxi, P.R. China 7 Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, P.R. China * These authors share co-first authorship Correspondence to: Min Fang, email: fangmin@hmc.edu.cn Keywords: esophageal cancer; NRS-2002; ECOG PS; treatment response; survival Received: June 06, 2017      Accepted: August 26, 2017      Published: October 19, 2017 ABSTRACT This study evaluated the prognostic effects of nutritional risk scores and performance status (PS) on unresectable locally advanced esophageal cancer (LAEC) patients who were treated with definitive concurrent chemoradiotherapy (dCRT). A total of 202 LAEC patients from four different cancer centers were retrospectively reviewed. Nutritional risk and PS were measured using the Nutritional Risk Screening 2002 (NRS-2002) scores and Eastern Cooperative Oncology Group (ECOG) scales. Outcomes were clinical response rate, overall survival (OS) and progression-free survival (PFS). Multivariate analysis of predictive factors of response to dCRT and survival were performed using a logistic regression and a Cox model, respectively. The majority of patients (71.8%) had an ECOG PS score of 0-1, and 52.5% (n=106) of patients were identified as having nutritional risk (NRS-2002 ≥3) upon treatment initiation. There was no correlation between NRS-2002 scores and ECOG PS (Spearman’s ρ=0.046; P =0.516). In multivariate analysis, NRS-2002 scores ( P =0.002, HR 2.805, 95%CI: 1.445-5.446) and ECOG PS ( P =0.015, HR 2.719, 95%CI: 1.218-6.067) were independent prognostic factors for the response to dCRT. NRS-2002 scores (OS: HR 1.530, 95%CI 1.059-2.209; P =0.023; PFS: HR 1.517, 95%CI 1.105-2.082; P =0.010) and ECOG PS (OS: HR 1.729, 95%CI 1.185-2.522; P =0.005; PFS: HR 1.678, 95%CI 1.179-2.387; P =0.004) were both independent prognostic factors for OS and PFS. In conclusions, NRS-2002 scores and ECOG PS scales both have prognostic effects on clinical response and survival in LAEC, but a significant association of NRS-2002 scores and ECOG PS were not observed.