Time course of serum C-reactive protein levels during induction chemoradiotherapy and its correlation with treatment response and survival in patients with advanced esophageal squamous cell carcinoma

Abstract

Preoperative serum C-reactive protein (CRP) levels have been shown to be of prognostic significance in patients with advanced esophageal carcinoma. However, the clinical significance of serum CRP levels in patients with unresectable or marginally resectable tumors in the absence of induction therapy has not been fully elucidated in relation to treatment response and prognosis. Thirty-four patients with clinical T3-T4 esophageal squamous cell carcinoma who underwent induction chemoradiotherapy (CRT) followed by esophagectomy were enrolled in this retrospective study. Serum CRP levels were measured during the course of CRT, i.e., prior to, during (1, 2, 3 and 4 weeks following initiation) and after CRT (prior to surgery). The association between CRP levels, CRT response and survival was analyzed. Elevated serum CRP levels exhibited a favorable decrease 2-3 weeks following CRT initiation in pathological responders and CRP 0.3 mg/dl (67.6% of patients in this study), CRP