Department of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, OH 44106, USA.
Department of Radiation Oncology, Washington University School of Medicine and Alvin J. Siteman Comprehensive Cancer Center, St. Louis, MO 63110, USA.
Int J Environ Res Public Health. 2020 Oct 30;17(21):7995. doi: 10.3390/ijerph17217995.
The Systemic Immune-Inflammation Index (SII) is an important marker of immune function, defined as the product of neutrophil-to-lymphocyte ratio (NLR) and platelet count (P). Higher baseline SII levels have been associated with improved survival in various types of cancers, including lung cancer. Data were obtained from PROCLAIM, a randomized phase III trial comparing two different chemotherapy regimens pemetrexed + cisplatin (PEM) vs. etoposide + cisplatin (ETO), in combination with radiotherapy (RT) for the treatment of stage III non-squamous non-small cell lung cancer (NSCLC). We aimed to determine if SII measured at the mid-treatment window for RT (weeks 3-4) is a significant predictor of survival, and if the effect of PEM vs. ETO differs by quartile (Q) level of SII. Hazard-ratios (HR) for survival were estimated using a proportional hazards model, accounting for the underlying correlated structure of the data. A total of 548 patients were included in our analysis. The median age at baseline was 59 years. Patients were followed for a median of 24 months. Adjusting for age, body mass index, sex, race, and chemotherapy regimen, SII was a significant mid-treatment predictor of both overall (adjusted HR (aHR) = 1.6, < 0.0001; OS) and progression-free (aHR = 1.3, = 0.0072; PFS) survival. Among patients with mid-RT SII values above the median (6.8), those receiving PEM (vs. ETO) had superior OS ( = 0.0002) and PFS ( = 0.0002). Our secondary analysis suggests that SII is an informative mid-treatment marker of OS and PFS in locally advanced non-squamous NSCLC.
系统免疫炎症指数（SII）是免疫功能的一个重要标志物，定义为中性粒细胞与淋巴细胞比值（NLR）和血小板计数（P）的乘积。较高的基线 SII 水平与各种类型癌症（包括肺癌）的生存改善相关。这些数据来自 PROCLAIM 试验，这是一项比较培美曲塞+顺铂（PEM）与依托泊苷+顺铂（ETO）两种不同化疗方案联合放疗（RT）治疗 III 期非鳞状非小细胞肺癌（NSCLC）的随机 III 期试验。我们旨在确定在 RT 治疗中期（第 3-4 周）测量的 SII 是否是生存的重要预测指标，以及 PEM 与 ETO 的疗效是否因 SII 的四分位（Q）水平而不同。使用比例风险模型估计生存的风险比（HR），该模型考虑了数据的潜在相关结构。共有 548 例患者纳入我们的分析。基线时的中位年龄为 59 岁。中位随访时间为 24 个月。调整年龄、体重指数、性别、种族和化疗方案后，SII 是总生存（调整 HR（aHR）=1.6，<0.0001；OS）和无进展生存（aHR=1.3，=0.0072；PFS）的显著中期预测指标。在 RT 中期 SII 值高于中位数（6.8）的患者中，接受 PEM（与 ETO 相比）的 OS（=0.0002）和 PFS（=0.0002）更好。我们的二次分析表明，SII 是局部晚期非鳞状 NSCLC 中 OS 和 PFS 的一个有意义的中期标志物。
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