title: Clinical observation of gene expression-guided chemoradiation therapy for nonsurgical esophageal squamous cell carcinoma patients: a retrospective analysis of 36 cases.
abstract: OBJECTIVE
  To make an informed choice of chemotherapy drugs according to the oncogene mRNA expression and to explore whether it could increase the survival rate of patients.
  
  
  METHODS
  The study retrospectively analyzed 36 cases of nonsurgical esophageal squamous cell carcinoma patients treated at the Center for Oncology of Shandong Provincial Hospital from December 1, 2010, to November 1, 2013. Intensity-modulated radiation therapy was used for the treatment with a conventional radiotherapy dose of 60-66 Gy. Chemotherapy started 1-5 weeks after radiation therapy. The selection of the chemotherapy drug was based on the mRNA expression levels of excision repair cross-complementation 1, thymidylate synthetase, ribonucleotide reductase M1, and β-tubulin isotype III. The objective response rate, progression-free survival, and overall survival were observed.
  
  
  RESULTS
  The reason for poor prognosis of patients with high expression of excision repair cross-complementation 1 was unknown. No correlation was observed between patient survival and expression of thymidylate synthetase, ribonucleotide reductase M1, and β-tubulin isotype III. Complete response, partial response, stable disease, and progressive disease were observed in 25, five, three, and three patients, respectively. The objective response rate was 83.3%. The 1-year, 2-year, and 3-year progression-free survival rates were 79.8%, 58.9%, and 54.4%, respectively. The 1-year, 2-year, and 3-year overall survival rates were 83.3%, 68.1%, and 58.4%, respectively.
  
  
  CONCLUSIONS
  Selecting the chemotherapy drug according to the oncogene expression, combined with radiation therapy, could increase the 3-year survival rate in nonsurgical esophageal squamous cell carcinoma patients. Such conclusion needs to be further confirmed using a larger sample size.
authors.affiliation: Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: Honghai
authors.initials: H
authors.lastname: Dai
authors.affiliation: Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: Dongxiao
authors.initials: D
authors.lastname: Lv
authors.affiliation: Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: A Lei
authors.initials: AL
authors.lastname: Feng
authors.affiliation: Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: Weibin
authors.initials: W
authors.lastname: Shu
authors.affiliation: Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China.
authors.forename: Junqing
authors.initials: J
authors.lastname: Han
keywords: chemoradiation therapy; esophageal squamous cell carcinoma; gene expression; survival