Evaluation of systemic inflammation based prognostic scores in patients with advanced oesophageal cancer receiving palliative radiotherapy.

Authors

Ross Dolan

Ross Dolan

University of Glasgow Academic Unit of Surgery, Glasgow, United Kingdom

Ross Dolan , Elliot Tilling , Chia Y Kong , Nicholas James MacLeod , Stephen Thomas McSorley , James Hugh Park , Paul Glen , Paul G. Horgan , Barry Laird , Donald C McMillan

Organizations

University of Glasgow Academic Unit of Surgery, Glasgow, United Kingdom, Glasgow University, Glasgow, United Kingdom, CRUK Clinical Trials Unit, Glasgow, United Kingdom, University of Glasgow, Glasgow, United Kingdom, NHS Greater Glasgow and Clyde Place, Glasgow, United Kingdom, University of Edinburgh, Edinburgh, United Kingdom

Research Funding

Other

Background: The presence of a systemic inflammatory response (SIR) in patients with advanced cancer is an increasingly recognised prognostic domain and is commonly assessed by the Glasgow Prognostic Score (GPS) and modified Glasgow Prognostic Score (mGPS). However, little work has been carried out to evaluate their role in palliative radiotherapy. The aim of the present study was to compare the prognostic value of the GPS/mGPS in patients with advanced oesophageal cancer receiving palliative radiotherapy. Methods: Those patients receiving palliative radiotherapy for oesophageal cancer between 2010 and 2015 were examined (n=194). After exclusions the following demographic data was recorded sex, age, indication for radiotherapy, time from treatment to death/last clinic visit, medical comorbidities, tumour and radiotherapy location/dose, CRP, albumin, and differential blood counts. GPS, mGPS, NLR, PLR and LMR were all calculated and Cox regression analysis carried out in SPSS. Results: Patients who had undergone non-oesophageal/neoadjuvant radiotherapy (n=2) or died within 30 days of treatment administration were excluded (n=22). Of the remaining 170 analysed, 112 (66%) were male and the median age was 72 (Range: 43-91). The most common clinical indications for radiotherapy were dysphagia (n=142), weight loss (n=81) and pain (n=50). Medical comorbidities varied with the most common being hypertension (n=83), ischaemic heart disease (n=46) and COPD (n=42). At the time of analysis, 170 (100%) of the patients were dead with median survival of 6 months (Range: 1-81 month). On univariate six month cancer specific survival analysis, TNM stage (p=0.028), GPS (p<0.001) and mGPS (p<0.001) were significantly associated with poor survival. On multivariate analysis of the significant variables, only mGPS (HR: 2.28, 95%CI 1.29-4.01, p=0.004) and TNM stage (HR: 1.71 95%CI 1.09-2.69, p=0.020) remained independently associated with survival. Conclusions: In the palliative radiotherapy setting, systemic inflammation based scores (GPS/mGPS) had prognostic value and the mGPS had independent prognostic value.

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Abstract Details

Meeting

2018 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach

Track

Cancers of the Esophagus and Stomach

Sub Track

Prevention, Diagnosis, and Screening

Citation

J Clin Oncol 36, 2018 (suppl 4S; abstr 21)

DOI

10.1200/JCO.2018.36.4_suppl.21

Abstract #

21

Poster Bd #

D21

Abstract Disclosures

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