Objective:To investigate the value of mean platelet volume-to-lymphocyte ratio (MPVLR) in assessing the prognosis of elderly patients treated with radiotherapy for esophageal cancer.Methods:A retrospective case series study was conducted. The clinical data of 102 elderly esophageal cancer patients who received radiotherapy from September 2015 to September 2020 in Zhongshan Hospital Affiliated to Xiamen University were retrospectively analyzed. After admission, all patients were tested for serum mean platelet volume and lymphocyte levels by using a fully automated hematology analyzer, and MPVLR was calculated. The optimal cut-off value of MPVLR was determined based on the receiver operating characteristic (ROC) curve. The patients were grouped according to the optimal cut-off value of MPVLR, and clinicopathological characteristics of the two groups were compared. The Kaplan-Meier method was used to analyze the overall survival of patients after radiotherapy, and the multivariate Cox proportional risk model was used to analyze the factors affecting the overall survival of patients after radiotherapy.Results:The age of 102 patients was (77±3) years; there were 58 male cases, 44 female cases; 67 cases of middle and high differentiation, 35 cases of low differentiation; 65 cases of TNM stage Ⅰ-Ⅱ, 37 cases of stage Ⅲ-Ⅳ. ROC curve analysis showed that the area under the curve of MPVLR predicting the overall survival of esophageal cancer patients after radiotherapy was 0.905 (95% CI: 0.855-0.955). The optimal cut-off value of MPVLR was 5.442. All patients were divided into the low MPVLR group (MPVLR ≤ 5.442, 60 cases) and the high MPVLR group (MPVLR > 5.442, 42 cases) according to the optimal cut-off value of MPVLR. The proportion of patients with low differentiation and stage Ⅲ-Ⅳ in the high MPVLR group was higher than that in the low MPVLR group (all P < 0.001). The 3-year overall survival rate after radiotherapy in the high-MPVLR group was lower than that in the low-MPVLR group (23.81% vs. 51.67%), and the difference in the overall survival of both groups was statistically significant ( P < 0.05). The differences in the overall survival of elderly esophageal cancer patients with different differentiation and TNM staging after radiotherapy were statistically significant (all P < 0.05). Univariate Cox regression analysis showed that TNM stage Ⅲ-Ⅳ ( HR = 3.034, 95% CI: 1.805-5.101), low differentiation ( HR = 2.872, 95% CI: 1.791-4.606), and MPVLR > 5.442 ( HR = 3.789, 95% CI: 2.000-7.178) were independent risk factors for overall survival in elderly patients with esophageal cancer after radiotherapy (all P < 0.001). Conclusions:MPVLR before radiotherapy is closely related to the prognosis of elderly patients with esophageal cancer, and patients with MPVLR > 5.442 may have poorer overall survival after radiotherapy.

Objective To evaluate the therapeutic efficacy of radiotherapy with reduced target volume in glioblastoma multiforme patients following surgical treatment, and to provide a basis for the development of postoperative radiotherapy regimens for glioblastoma multiforme. Methods The medical records of 29 patients with glioblastoma multiforme receiving postoperative adjuvant radiochemotherapy with a reduced radiation target were retrospectively reviewed. The gross tumor volume (GTV) included postoperative tumor cavity and residual lesions, and the clinical target volume (CTV) was GTV plus 2.5 cm margin with adaptation according to the affected organs and anatomic structures. GTV and CTV received intensity-modulated radiotherapy with concomitant boost at 60 Gy/30 fractions and 54 Gy/30 fractions, respectively. The progression-free survival (PFS) and site of recurrence were analyzed. Results The patients were followed up until March 2022. Among the 29 patients with glioblastoma multiforme, 3 showed recurrence-free survival of 52, 20, and 19 months, respectively. Among the 26 patients with recurrent glioblastoma multiforme, there were no case with recurrence in CTV, 25 cases with recurrence in GTV (including 3 cases with intracranial dissemination), and one case with intracranial dissemination and without recurrence in GTV. The median PFS was 7 months (4 to 15 months). Among the 3 patients with recurrence in GTV and intracranial dissemination, one showed primary lesion in the right frontal parietal lobe and the metastatic lesion in the right occipital lobe, one primary lesion in the right occipital lobe and multiple metastatic lesions in the cerebellum, and one primary lesion in the left frontal lobe and the metastatic lesion in the right frontal lobe. The PFS was 4 to 5 months for seven patients receiving partial resection, and 6 to 15 months for patients receiving total and subtotal resection. The three recurrence-free survivors all underwent total resection. Conclusion Recurrence in target volume still prevails in patients with glioblastoma multiforme receiving postoperative radiotherapy with reduced target volume, and 60 Gy/30 fractions fail to control the tumor cavity and residual lesions of glioblastoma multiforme.