Tumor Biology

, Volume 31, Issue 4, pp 333–340 | Cite as

Predictors of sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma

  • Yan Yi
  • Baosheng Li
  • Hongfu Sun
  • Zicheng Zhang
  • Heyi Gong
  • Hongsheng Li
  • Wei Huang
  • Zhongtang Wang
Research Article


The purpose of this study was to investigate clinical–biological factors which could predict the sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma (ESCC). One hundred eighty-one patients with stages I–IV ESCC were evaluated. The cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen (CEA), albumin (A) as well as hemoglobin (HB) concentration were measured before the initiation of chemoradiotherapy (CRT). The cutoff values of CYFRA21-1, CEA, and A were defined as 3.4 ng/ml, 3.3 ng/ml, 3.5 g/dl, respectively. HB was divided into three levels: <12.0, 12.0–14.0, and >14.0 g/dl. Clinical factors such as sex, age, tumor location, primary cancer length, and tumor–node–metastasis stage were also evaluated. The effective rate (complete response + partial response) of the primary tumor estimated by computed tomography was 60.71% (17 out of 28) in patients with CEA high group while 92.54% (62 out of 67) in patients with CEA low group (P = 0.000) and 62.50% (20 out of 32) in patients with CYFRA21-1 high group while 92.98% (53 out of 57) in patients with CYFRA21-1 low group (P = 0.000). HB levels before and during CRT were also associated with the effectiveness (P = 0.005, 0.033, respectively). HB levels before CRT at 12.0–14.0 g/dl were associated with the best effectiveness, followed by >14.0 and <12.0 g/dl (effective rates 88.89% vs. 83.75%, 62.07%, respectively, P = 0.005). HB levels during CRT also showed similar results (effective rates 87.80% vs. 85.41%, 70.59%, respectively, P = 0.033). Furthermore, according to numbers of the above risk factors, the sensitivity of CRT was higher in patients with zero to one risk factors than those with two to four risk factors (P = 0.023). CYFRA21-1 and CEA as well as HB and their combination may be helpful in predicting the sensitivity to CRT of ESCC. However, the results should be further confirmed in larger, more homogeneous studies.


Esophageal squamous cell carcinoma Chemoradiotherapy Cytokeratin 19 fragment antigen 21-1 Carcinoembryonic antigen Hemoglobin Albumin 


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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2010

Authors and Affiliations

  • Yan Yi
    • 1
  • Baosheng Li
    • 1
  • Hongfu Sun
    • 1
  • Zicheng Zhang
    • 1
  • Heyi Gong
    • 1
  • Hongsheng Li
    • 1
  • Wei Huang
    • 1
  • Zhongtang Wang
    • 1
  1. 1.Departments of Radiation OncologyShandong Cancer Hospital and InstituteJinanPeople’s Republic of China

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