Background There are no standard therapeutic strategies for local lymph node (LN) recurrence after radical resection of oesophageal squamous cell carcinoma (ESCC), and prognostic risk factors remain controversial. We assessed clinical outcomes and prognostic factors of chemoradiotherapy (CRT) or radiotherapy (RT) for LN recurrence of ESCC after curative resection. Methods A total of 117 ESCC patients with LN recurrence after radical resection receiving salvage treatment at our hospital were retrospectively reviewed from 2014 to 2017. Overall survival (OS) was estimated using the Kaplan–Meier method; clinical characteristics were assessed using the Log rank test in the univariate analysis. Multivariate prognostic analysis was performed using the Cox proportional hazard model. Results With a median follow-up of 19 months, the 1-, 2- and 3-year OS rates were 75.2%, 40.2% and 27.4%, respectively. The median survival time (MST) was 19.0 months. On univariate analysis for OS, pathological TNM stage, number of LN metastasis, LN maximum (Max) diameter, salvage treatment mode and tumor response were significantly associated with OS (P = 0.0074, P = 0.015, P = 0.0011, P = 0.028, P < 0.000, respectively). On multivariate analysis, tumor response [Response vs No-response hazard ratio (HR), 2.43; 95% confidence interval (CI), 1.53–3.90, P < 0.000] and LN Max diameter (≤28 mm vs >28 mm HR, 2.07; 95% CI, 1.33–3.32, P = 0.012) were independent prognostic factors. Conclusion Salvage CRT or RT was safe and effective for treating LN recurrence after radical resection in ESCC. Patients with the small LN Max diameter (≤28 mm) and obtained response after salvage therapy appeared to achieve long-term OS.
Objective: To investigate the capability of computed tomography (CT) radiomic features to predict the therapeutic response and local control of the loco-regional recurrence lymph node (LN) after curative esophagectomy by chemoradiotherapy (CRT).Methods: This retrospective study included 129 LN from 77 patients (training cohort: 102 LN from 59 patients; validation cohort: 27 LN from 18 patients) with postoperative esophageal squamous cell carcinoma (ESCC). The region of the tumor was contoured in pretreatment contrast-enhanced CT images. The least absolute shrinkage and selection operator (LASSO) with logistic regression was used to identify radiomic predictors in the training cohort. Model performance was evaluated using the area under the receiver operating characteristic curves (AUC). The Kaplan-Meier method was used to determine the local recurrence time of cancer.Results: Seven features were selected to construct a radiomics model for predicting therapeutic response. The AUCs in the training and validated cohorts were 0.777 (95%CI: 0.667–0.878) and 0.765(95%CI: 0.556–0.975), respectively. A significant difference of radiomic score (Rad-score) between the response and non-response was observed in the two cohorts (P < 0.001, 0.034, respectively). Two features were identified for classifying whether to relapse in two years. AUC was 0.857(95%CI: 0.780–0.935) in the training cohort. The local control time of the high Rad-score group was higher than the low group in both cohorts (P < 0.001 and 0.025, respectively). After the Cox regression analysis, the Rad-score indicated high-risk factors for local recurrence within two years.Conclusions: The radiomics approach can be used as a potential imaging biomarker to predict treatment response and local control of recurrence LN in ESCC patients.
Measurements of Deeply Virtual Compton Scattering on nuclear targets are reported, performed using the 27.6 GeV longitudinally polarized lepton beam of HERA and various nuclear targets of the HERMES experiment. All possible azimuthal asymmetries are extracted, with a detailed estimation of systematic uncertainties. The asymmetries of interest for coherent-enriched and incoherent-enriched regions are compared to those for the free proton, and in both cases the ratios are found to be compatible with unity.
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