Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Banqiao, Taipei, 22061, Taiwan.
Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan.
BMC Cancer. 2022 Jun 5;22(1):615. doi: 10.1186/s12885-022-09732-9.
To analyze clinical characteristics in the prediction of death within 1 year in advanced oropharyngeal cancer patients treated with chemoradiation.
One hundred forty-seven advanced oropharyngeal cancer patients who underwent curative-intent chemoradiation treatment were retrospectively enrolled. The pre-treatment clinical parameters including inflammatory markers were reviewed.
The 1-year death rate for all patients was 29% [95% confidence interval (CI): 23-37%]. In multivariate logistic regression analysis, hemoglobulin (Hb) < 13.5 g/dl was an independent indicator of death within 1-year [Odds ratio (OR) 5.85, 95% CI 2.17-15.75, p < 0.001]. Systemic immune inflammation (SII) ≥ 1820 was also a significant factor for prediction of death within 1 year (OR 4.78, 95% CI 1.44-15.85, p = 0.011). We further used gander, age, Hb and SII to develop a nomogram to predict death within 1 year. The c-index of the model was 0.75 (95%CI 0.66-0.83). For patients with low nomogram score (< 14) versus high nomogram score (≥ 14), the 1-year and 2-year OS rates were 91 and 71% versus 53 and 29%, respectively. (p < 0.001). A difference in the disease persistence or recurrence rate between patients with high and low nomogram score was significant (73 and 28%, respectively; p < 0.001).
The pre-treatment Hb < 13.5 g/dl and SII ≥ 1820 are associated with higher risks of death within 1-year in patients with advanced oropharyngeal cancers. Nomogram can aid in patient counseling and treatment modality adjustment. The development of a more effective treatment protocol for patients with high nomogram score will be essential.
分析接受放化疗的晚期口咽癌患者 1 年内死亡的临床特征，以预测其预后。
回顾性分析 147 例接受根治性放化疗的晚期口咽癌患者的临床资料，包括炎症标志物等。
所有患者的 1 年死亡率为 29%[95%可信区间（CI）：23%-37%]。多因素 logistic 回归分析显示，血红蛋白（Hb）<13.5g/dl 是 1 年内死亡的独立预测因素[比值比（OR）5.85，95%CI 2.17-15.75，p<0.001]。全身免疫炎症指数（SII）≥1820 也是 1 年内死亡的重要预测因素（OR 4.78，95%CI 1.44-15.85，p=0.011）。我们进一步采用性别、年龄、Hb 和 SII 构建了一个预测 1 年内死亡的列线图模型。该模型的 C 指数为 0.75（95%CI 0.66-0.83）。对于低列线图评分（<14）和高列线图评分（≥14）的患者，1 年和 2 年总生存率分别为 91%和 71%与 53%和 29%（p<0.001）。高列线图评分和低列线图评分患者的疾病持续或复发率差异显著（分别为 73%和 28%，p<0.001）。
晚期口咽癌患者治疗前 Hb<13.5g/dl 和 SII≥1820 与 1 年内死亡风险增加相关。列线图可用于辅助患者咨询和治疗方式调整。对于高列线图评分患者，制定更有效的治疗方案至关重要。
