林宇, 王鑫, 王澜, 章文成, 赵一电, 葛小林, 沈文斌, 王平, 庞青松, 王晓敏, 孙新臣, 张开贤, 胡苗苗, 李苓, 郝崇礼, 乔学英, 李高峰, 徐勇刚, 刘妙玲, 郄帅, 王雅棣, 韩春, 祝淑钗, 路娜, 许元基, 李伟光, 张怡萍, 陈俊强, 肖泽芬. 食管鳞癌患者根治性放疗预后列线图模型的构建—泛京津冀多中心回顾分析（3JECROG R-03A）[J]. 中国肿瘤临床, 2023, 50(12): 595-600. DOI: 10.12354/j.issn.1000-8179.2023.20221711
引用本文: 林宇, 王鑫, 王澜, 章文成, 赵一电, 葛小林, 沈文斌, 王平, 庞青松, 王晓敏, 孙新臣, 张开贤, 胡苗苗, 李苓, 郝崇礼, 乔学英, 李高峰, 徐勇刚, 刘妙玲, 郄帅, 王雅棣, 韩春, 祝淑钗, 路娜, 许元基, 李伟光, 张怡萍, 陈俊强, 肖泽芬. 食管鳞癌患者根治性放疗预后列线图模型的构建—泛京津冀多中心回顾分析（3JECROG R-03A）[J]. 中国肿瘤临床, 2023, 50(12): 595-600. DOI: 10.12354/j.issn.1000-8179.2023.20221711
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Yu Lin, Xin Wang, Lan Wang, Wencheng Zhang, Yidian Zhao, Xiaolin Ge, Wenbin Shen, Ping Wang, Qingsong Pang, Xiaomin Wang, Xinchen Sun, Kaixian Zhang, Miaomiao Hu, Ling Li, Chongli Hao, Xueying Qiao, Gaofeng Li, Yonggang Xu, Miaoling Liu, Shuai Qie, Yadi Wang, Chun Han, Shuchai Zhu, Na Lu, Yuanji Xu, Weiguang Li, Yiping Zhang, Junqiang Chen, Zefen Xiao. A national multicenter retrospective clinical study to develop a prognostic nomogram for patients with esophageal squamous cell carcinoma based on definitive radiotherapy (3JECROG R-03A)[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 595-600. DOI: 10.12354/j.issn.1000-8179.2023.20221711
Citation: Yu Lin, Xin Wang, Lan Wang, Wencheng Zhang, Yidian Zhao, Xiaolin Ge, Wenbin Shen, Ping Wang, Qingsong Pang, Xiaomin Wang, Xinchen Sun, Kaixian Zhang, Miaomiao Hu, Ling Li, Chongli Hao, Xueying Qiao, Gaofeng Li, Yonggang Xu, Miaoling Liu, Shuai Qie, Yadi Wang, Chun Han, Shuchai Zhu, Na Lu, Yuanji Xu, Weiguang Li, Yiping Zhang, Junqiang Chen, Zefen Xiao. A national multicenter retrospective clinical study to develop a prognostic nomogram for patients with esophageal squamous cell carcinoma based on definitive radiotherapy (3JECROG R-03A)[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 595-600. DOI: 10.12354/j.issn.1000-8179.2023.20221711
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食管鳞癌患者根治性放疗预后列线图模型的构建—泛京津冀多中心回顾分析（3JECROG R-03A）

A national multicenter retrospective clinical study to develop a prognostic nomogram for patients with esophageal squamous cell carcinoma based on definitive radiotherapy (3JECROG R-03A)

    摘要
  • 摘要:
      目的  构建列线图（nomogram）模型以预测食管鳞癌患者的预后情况，指导个体化治疗。
      方法  回顾性分析2002年1月至2016年12月国内10家放疗中心（泛京津冀食管癌协作组-3JECROG）收治的2 680例根治性放疗食管鳞癌患者资料，随机分为训练组和验证组,根据训练组的预后因素构建nomogram模型，并进行训练组内部和验证组外部验证。分别以nomogram模型与AJCC/UICC分期评估两组患者预后及临床获益。
      结果  全组1、3、5年生存率分别为 69.0%、37.7%、31.0%。多因素分析肿瘤部位、TNM分期、原发肿瘤体积和是否同步化疗是影响食管癌的独立预后因素（均P<0.05）。在训练组和验证组中nomogram模型的一致性指数（C-index）、 AUC值均高于AJCC/UICC分期（均P<0.001）。基于nomogram模型分为低、中、高风险亚组与AJCC/UICC分期比较，nomogram模型的生存曲线之间具有显著性差异（P<0.001），且1、3、5年的总生存临床决策曲线（decision curve analysis，DCA）下面积均具有显著性差异。
      结论   本研究构建的nomogram模型较AJCC/UICC分期具有更好的预测能力，有助于食管癌患者的预后判断及指导个体化治疗。

     

    Abstract:
      Objective  To develop a nomogram to predict prognosis in patients with esophageal squamous cell carcinoma (ESCC) and guide individualized treatment.
      Methods  From January 2002 to December 2016, a total of 2,680 patients with ESCC recruited from 10 national radiotherapy center (3JECROG R-03A) treated with definitive radiotherapy were randomly assigned into a training group and a validation group. A nomogram was built based on prognostic factors associated with the training group and validated using external and internal cohorts. Prognosis and clinical benefits were compared between the nomogram and the AJCC/UICC staging. Results: The respective 1-, 3-, and 5-year overall survival (OS) rates of the whole cohort were 69.0%, 37.7%, and 31.0%. Tumor location, TNM stage, primary tumor volume, and concurrent chemoradiotherapy were found to be independent prognostic factors by multivariate analyses (all P<0.05). Nomogram C-indices and AUC values in the training and validation groups were all significantly higher than those obtained from AJCC/UICC staging. Low, medium, and high risk groups were identified using training nomogram scores. Compared with those obtained by AJCC/UICC staging, the OS curves were separated better, and the areas under the 1-, 3-, and 5-decision curve analysis (DCA) curves were larger when using the nomogram.
      Conclusions  In comparison to AJCC/UICC staging, the nomogram more accurately predicted prognosis, contributing to improved prognostic prediction and personalized treatment.

     

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