Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao District, 220, New Taipei City, Taiwan.
Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Eur Arch Otorhinolaryngol. 2024 Jan;281(1):369-377. doi: 10.1007/s00405-023-08187-3. Epub 2023 Aug 18.
To evaluate the pre-treatment and post-treatment clinical factors associated with rate of survival at 1, 3, and 5 years in stage IV oropharyngeal cancer patients treated with concurrent chemoradiation with/without neoadjuvant chemotherapy.
This retrospective cohort study involved 128 Stage IV oropharyngeal cancer patients that were treated at our tertiary referral center between 2008 and 2020. The pre-treatment and post-treatment clinical parameters including nutritional status and inflammatory markers were retrospectively reviewed.
The 5-year overall survival rate for all patients was 36.72%. The disease-specific survival (DSS) at 1-year and 3-year were 80% and 63%, whereas the disease-free survival (DFS) at 1-year and 3-year were 49% and 40%, respectively. In multivariate analyses, pretreatment hemoglobin (Hb) < 12 g/dL (hazard ratio [HR] 2.551, 95% confidence interval [CI] 1.366-4.762, p = 0.003), pretreatment systemic immune inflammation (SII) ≥ 1751 (HR 2.173, 95% CI 1.015-4.652, p = 0.046), and posttreatment systemic inflammation response index (SIRI) ≥ 261 (HR 2.074, 95% CI 1.045-4.115, p = 0.037) were independent indicators for worsened DSS. Pretreatment Hb < 12 g/dl (HR 1.692, 95% CI 1.019-2.809, p = 0.032), pretreatment SII ≥ 1751 (HR 1.968, 95% CI 1.061-3.650, p = 0.032), and posttreatment SII ≥ 1690 (HR 1.922, 95% CI 1.105-3.345, p = 0.021) were independent indicators for worsened DFS. A nomogram was developed using pretreatment Hb, pretreatment SII, and posttreatment SIRI to forecast DSS.
The pretreatment Hb, pretreatment SII, posttreatment SII, and posttreatment SIRI are associated with survival in patients with stage IV oropharyngeal cancers. The developed nomogram aids in survival prediction and treatment adjustment.
评估接受同期放化疗联合/不联合新辅助化疗的 IV 期口咽癌患者的治疗前和治疗后临床因素与 1、3 和 5 年生存率的关系。
本回顾性队列研究纳入了 2008 年至 2020 年在我们的三级转诊中心接受治疗的 128 例 IV 期口咽癌患者。回顾性分析了治疗前和治疗后的临床参数，包括营养状况和炎症标志物。
所有患者的 5 年总生存率为 36.72%。1 年和 3 年的疾病特异性生存率（DSS）分别为 80%和 63%，而 1 年和 3 年的无病生存率（DFS）分别为 49%和 40%。多因素分析显示，治疗前血红蛋白（Hb）<12 g/dL（风险比[HR]2.551，95%置信区间[CI]1.366-4.762，p=0.003）、治疗前全身免疫炎症（SII）≥1751（HR 2.173，95%CI 1.015-4.652，p=0.046）和治疗后全身炎症反应指数（SIRI）≥261（HR 2.074，95%CI 1.045-4.115，p=0.037）是 DSS 恶化的独立指标。治疗前 Hb<12 g/dl（HR 1.692，95%CI 1.019-2.809，p=0.032）、治疗前 SII≥1751（HR 1.968，95%CI 1.061-3.650，p=0.032）和治疗后 SII≥1690（HR 1.922，95%CI 1.105-3.345，p=0.021）是 DFS 恶化的独立指标。使用治疗前 Hb、治疗前 SII 和治疗后 SIRI 制定了一个列线图来预测 DSS。
治疗前 Hb、治疗前 SII、治疗后 SII 和治疗后 SIRI 与 IV 期口咽癌患者的生存相关。所开发的列线图有助于生存预测和治疗调整。
