Selzer Edgar, Grah Anja, Heiduschka Gregor, Kornek Gabriela, Thurnher Dietmar
Department of Radiotherapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria,
Strahlenther Onkol. 2015 Jun;191(6):486-94. doi: 10.1007/s00066-014-0803-1. Epub 2015 Jan 13.
Inflammation-based scoring systems have potential value in evaluating the prognosis of cancer patients; however, detailed comparative analyses in well-characterized head and neck cancer patient collectives are missing.
We analyzed overall survival (OS) in locally advanced head and neck cancer patients who were treated with curative intent by primary radiotherapy (RT) alone, by RT in combination with cetuximab (RIT) or with cisplatin (RCHT), and by primary surgery followed by postoperative radiotherapy (PORT). The primary RT collective (N = 170) was analyzed separately from the surgery plus RT group (N = 148). OS was estimated using the Kaplan-Meyer method. Cox proportional-hazard regression models were applied to compare the risk of death among patients stratified according to risk factors and the inflammation-based Glasgow Prognostic Score (GPS), the modified GPS (mGPS), the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the prognostic index (PI).
A prognostic relevance of the scoring systems for OS was observed in the primarily irradiated, but not in the PORT collective. OS was 35.5, 18.8, and 15.4 months, respectively, according to GPS 0, 1, and 2. OS according to mGPS 0-2 was identical. The PLR scoring system was not of prognostic relevance, while OS was 27.3 months in the NLR 0 group and 17.3 months in the NLR 1 group. OS was 35.5 months in PI 0, 16.1 months in PI 1, and 22.6 months in PI 2.
GPS/mGPS scoring systems are able to discriminate between three risk groups in primarily, but not postoperatively irradiated locally advanced head and neck cancer patients.
基于炎症的评分系统在评估癌症患者预后方面具有潜在价值；然而，在特征明确的头颈癌患者群体中缺乏详细的比较分析。
我们分析了局部晚期头颈癌患者的总生存期（OS），这些患者接受了单纯根治性原发放疗（RT）、放疗联合西妥昔单抗（RIT）或顺铂（RCHT）治疗，以及原发手术加术后放疗（PORT）。原发RT组（N = 170）与手术加RT组（N = 148）分别进行分析。采用Kaplan-Meier法估计OS。应用Cox比例风险回归模型比较根据风险因素和基于炎症的格拉斯哥预后评分（GPS）、改良GPS（mGPS）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及预后指数（PI）分层的患者死亡风险。
在主要接受放疗的患者群体中观察到评分系统对OS具有预后相关性，但在PORT组中未观察到。根据GPS 0、1和2，OS分别为35.5个月、18.8个月和15.4个月。根据mGPS 0 - 2的OS相同。PLR评分系统不具有预后相关性，而NLR 0组的OS为27.3个月，NLR 1组为17.3个月。PI 0组的OS为35.5个月，PI 1组为16.1个月，PI 2组为22.6个月。
GPS/mGPS评分系统能够区分主要接受放疗而非术后放疗的局部晚期头颈癌患者的三个风险组。
