A CT-based novel model to predict pathological complete response of locally advanced esophageal squamous cell carcinoma to neoadjuvant PD-1 blockade in combination with chemotherapy

作者全名："Zhou, Hai-ying; Guo, Wen-wen; Ou, Jing; Li, Rui; Gui, Yan; Li, Li; Fu, Mao-yong; Zhang, Xiao-ming; Chen, Tian-wu"

作者地址："[Zhou, Hai-ying; Ou, Jing; Zhang, Xiao-ming; Chen, Tian-wu] Jinan Univ, Clin Med Coll 1, Guangzhou 510630, Guangdong, Peoples R China; [Zhou, Hai-ying; Guo, Wen-wen; Ou, Jing; Li, Rui; Zhang, Xiao-ming; Chen, Tian-wu] North Sichuan Med Coll, Affiliated Hosp, Sichuan Key Lab Med Imaging, Nanchong 637000, Sichuan, Peoples R China; [Zhou, Hai-ying; Guo, Wen-wen; Ou, Jing; Li, Rui; Zhang, Xiao-ming; Chen, Tian-wu] North Sichuan Med Coll, Dept Radiol, Affiliated Hosp, Nanchong 637000, Sichuan, Peoples R China; [Gui, Yan] North Sichuan Med Coll, Dept Oncol, Affiliated Hosp, Nanchong 637000, Sichuan, Peoples R China; [Li, Li] North Sichuan Med Coll, Affiliated Hosp, Dept Pathol, Nanchong 637000, Sichuan, Peoples R China; [Fu, Mao-yong] North Sichuan Med Coll, Affiliated Hosp, Dept Thorac Surg, Nanchong 637000, Sichuan, Peoples R China; [Chen, Tian-wu] Chongqing Med Univ, Dept Radiol, Affiliated Hosp 2, Chongqing 400010, Peoples R China; [Chen, Tian-wu] North Sichuan Med Coll, Med Imaging Key Lab Sichuan Prov, Affiliated Hosp, 1 Maoyuan South Rd, Nanchong 637000, Sichuan, Peoples R China; [Chen, Tian-wu] North Sichuan Med Coll, Dept Radiol, Affiliated Hosp, 1 Maoyuan South Rd, Nanchong 637000, Sichuan, Peoples R China; [Chen, Tian-wu] Chongqing Med Univ, Dept Radiol, Affiliated Hosp 2, 74 Linjiang Rd, Chongqing 400010, Peoples R China"

通信作者："Chen, TW (通讯作者)，North Sichuan Med Coll, Med Imaging Key Lab Sichuan Prov, Affiliated Hosp, 1 Maoyuan South Rd, Nanchong 637000, Sichuan, Peoples R China.; Chen, TW (通讯作者)，North Sichuan Med Coll, Dept Radiol, Affiliated Hosp, 1 Maoyuan South Rd, Nanchong 637000, Sichuan, Peoples R China.; Chen, TW (通讯作者)，Chongqing Med Univ, Dept Radiol, Affiliated Hosp 2, 74 Linjiang Rd, Chongqing 400010, Peoples R China."

来源：EUROPEAN JOURNAL OF RADIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001078975200001

JCR分区：Q1

影响因子：3.2

年份：2023

卷号：167

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Esophageal squamous cell carcinoma; Tomography X-ray computed; Pathological complete response; PD-1 blockade; Chemotherapy

摘要："Purpose: To develop a novel CT-based model to predict pathological complete response (pCR) of locally advanced esophageal squamous cell carcinoma (ESCC) to neoadjuvant PD-1 blockade in combination with chemotherapy.Methods: 117 consecutive patients with locally advanced ESCC were stratified into training cohort (n = 82) and validation cohort (n = 35). All patients underwent non-contrast and contrast-enhanced thoracic and upper abdominal CT before neoadjuvant PD-1 blockade in combination with chemotherapy (CTpre), and after two cycles of the therapy before esophagectomy (CTpost), respectively. Univariate analyses and binary logistic regression analyses of ESCC quantitative and qualitative CT features were performed to determine independent predictors of pCR. Prediction performance of the model developed with independent predictors from training cohort was evaluated by receiver operating characteristic (ROC) analysis, and validated by Kappa test in validation cohort.Results: In training cohort, the difference in CT attenuation between tumor and background normal esophageal wall obtained from CTpre (Delta TNpre), tumoral increased CT attenuation after contrast-enhanced scan from CTpost images (Delta Tpost) and gross tumor volume (GTV) from CTpre were independent predictors of pCR (odds ratio = 1.128 (95% confidence interval (CI): 0.997-1.277), 1.113 (95%CI: 0.965-1.239) and 1.133 (95%CI: 1.043-1.231), respectively, all P-values < 0.05). Logistic regression model equation (0.121 x Delta TNpre + 0.107 x Delta Tpost + 0.125 x GTV 9.856) to predict pCR showed the best performance with an area under the ROC of 0.876, compared with each independent predictor. The good performance was confirmed by the Kappa test (K value = 0.796) in validation cohort.Conclusions: This novel model can be reliable to predict pCR to neoadjuvant PD-1 blockade in combination with chemotherapy in locally advanced ESCC."

基金机构：National Natural Science Foundation of China [82271959]; Nanchong-University Cooperative Research Project [20SXQT0329]

基金资助正文："This work was supported by the National Natural Science Foundation of China (grant no. 82271959) , and the Nanchong-University Cooperative Research Project (grant no: 20SXQT0329) ."