Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China.
Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5859-5868. doi: 10.1007/s00405-022-07495-4. Epub 2022 Jul 18.
This study aimed to identify whether the platelet-to-lymphocyte ratio (PLR) correlated with the prognosis of patients with locally advanced hypopharyngeal squamous cell carcinoma (LA-HPSCC) undergoing radiotherapy combined with chemotherapy.
This study enrolled 103 patients diagnosed with LA-HPSCC and treated with radiotherapy combined with chemotherapy between 2008 and 2021. The optimal PLR cut-off value was chosen from the receiver operating characteristic (ROC) curve analysis. According to the cut-off value of PLR, patients were divided into two groups: a low PLR group (< 133.06) and a high PLR group (≥ 133.06). Propensity score matching (PSM) was used to balance the confounding factors between the two PLR groups. Univariate and multivariate Cox proportional hazard regression models, the Kaplan-Meier curve by the log-rank test, and univariate and multivariate Fine-Gray competing risk models were all used for assessment.
After PSM, 27 pairs were left, and the high PLR group correlated with higher local failure (sHR 6.91, 95% CI 2.14-22.35, p = 0.001) in the multivariate Fine-Gray competing risk model. Moreover, the low PLR group had a significantly longer 3-year progression-free survival (43.7% vs. 29.2%, p = 0.038) and overall survival (55.1% vs. 32.1%, p = 0.034) than the high PLR group had. Multivariate Cox analysis showed that a low PLR was an independent protective factor for PFS (HR 0.43, 95% CI 0.21-0.92, p = 0.019) and OS (HR 0.46, 95% CI 0.22-0.96, p = 0.039) in patients with LA-HPSCC.
Pretherapy PLR might be a factor in predicting the risk of local failure and survival in LA-HPSCC patients undergoing radiotherapy combined with chemotherapy.
本研究旨在探讨血小板与淋巴细胞比值（PLR）与接受放化疗的局部晚期下咽鳞状细胞癌（LA-HPSCC）患者预后的相关性。
本研究纳入了 2008 年至 2021 年间接受放化疗治疗的 103 例 LA-HPSCC 患者。通过受试者工作特征（ROC）曲线分析选择最佳 PLR 截断值。根据 PLR 的截断值，将患者分为两组：低 PLR 组（<133.06）和高 PLR 组（≥133.06）。采用倾向评分匹配（PSM）平衡两组间混杂因素。采用单因素和多因素 Cox 比例风险回归模型、对数秩检验的 Kaplan-Meier 曲线以及单因素和多因素 Fine-Gray 竞争风险模型进行评估。
PSM 后，共保留了 27 对，多因素 Fine-Gray 竞争风险模型显示，高 PLR 组与较高的局部失败风险相关（sHR 6.91，95%CI 2.14-22.35，p=0.001）。此外，低 PLR 组的 3 年无进展生存率（43.7%比 29.2%，p=0.038）和总生存率（55.1%比 32.1%，p=0.034）显著长于高 PLR 组。多因素 Cox 分析显示，低 PLR 是 LA-HPSCC 患者 PFS（HR 0.43，95%CI 0.21-0.92，p=0.019）和 OS（HR 0.46，95%CI 0.22-0.96，p=0.039）的独立保护因素。
治疗前 PLR 可能是预测接受放化疗的 LA-HPSCC 患者局部失败和生存风险的因素。
