Radiation-induced esophagitis and lung injury during esophageal squamous cell cancer therapy is correlated to tumor gene expression phenotype

Radiation esophagitis (RE) and Radiation-induced lung injury (RILI) are the main side effects of radiotherapy for esophageal squamous cell cancer (ESCC), which seriously affect the quality of life and therapeutic effect of patients. Then, how to reduce the incidence of RE and RILI is an important topic. We try to establish RE and RILI's prediction scheme based on the gene expression patterns in tumor tissues from patients with ESCC. A total of 37 patients who pathological preliminary diagnosed as ESCC and received radical radiotherapy from 2016 January 1 to 2019 December 31 were enrolled in this study. Use 3-plex qPCR to detect gene expression in ESCC. Our results showed that gene expressions in the Mitogen-activated protein (MAP) kinase signaling (HRAS, MAP2K1, MAPK1, CRAF and KRAS) were positively related to Severe RE (SRE), while Fibroblast growth factor (FGF) signaling showed a negative correlation. We established a c-Index calculation model to predict SRE. Receiver operating characteristic curve were applied to determine the prognostic value of the risk model. Besides, patients with SRE seem to be more easily to develop higher-level of RILI. Taken together, we constructed a novel radiotherapy response-related gene signature, which may be developed into a powerful tool for forecasting the risk of SRE in ESCC radiotherapy patients.