Kitagawa Mio, Kaguchi Juno, Someya Masanori, Fukushima Yuki, Hasegawa Tomokazu, Tsuchiya Takaaki, Gocho Toshio, Mafune Shoh, Ikeuchi Yutaro, Okuda Ryu, Ohguro Atsuya, Kamiyama Ryo, Ashina Ayato, Toshima Yuka, Hirohashi Yoshihiko, Torigoe Toshihiko, Sakata Koh-Ichi
Department of Radiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan.
Cancer Diagn Progn. 2024 Nov 3;4(6):789-796. doi: 10.21873/cdp.10397. eCollection 2024 Nov-Dec.
BACKGROUND/AIM: Radiotherapy (RT) for advanced oropharyngeal cancer (OPC) is effective, especially when combined with chemotherapy (CRT). However, its success can vary depending on factors, such as tumor stage, HPV infection (p16 status), and the patient's nutritional and immune status. This study examined the controlling nutritional status (CONUT) score and tumor immunity as predictive factors for treatment outcomes in OPC, aiming to develop a personalized risk score.
A retrospective analysis was conducted on 84 patients with OPC treated with definitive RT or CRT, and survival outcomes were compared based on various factors, including BMI, CONUT score, CD8 expression, and HLA class II expression.
We observed better overall survival (OS) rates in CD8-positive patients and those with higher HLA class II expression. The univariate analysis identified stage, p16 status, BMI, CONUT score, and CD8 expression as significantly associated with OS. In multivariate analysis, stage, BMI, and CONUT score remained significant predictors of OS. A risk scoring system was developed based on stage, p16 status, BMI, CONUT score, and CD8 expression. Patients were categorized into low-risk and high-risk groups, with significantly better survival in the low-risk group.
A combined risk score incorporating clinical, nutritional, and immune factors can improve the prediction of treatment outcomes for OPC patients. This risk stratification may enable personalized treatment plans and improve ΟS rates.
背景/目的：晚期口咽癌（OPC）的放射治疗（RT）是有效的，尤其是与化疗（CRT）联合使用时。然而，其成功率可能因肿瘤分期、人乳头瘤病毒感染（p16状态）以及患者的营养和免疫状态等因素而有所不同。本研究探讨了控制营养状况（CONUT）评分和肿瘤免疫作为OPC治疗结果的预测因素，旨在制定个性化风险评分。
对84例接受根治性RT或CRT治疗的OPC患者进行回顾性分析，并根据包括体重指数、CONUT评分、CD8表达和人类白细胞抗原II类表达等各种因素比较生存结果。
我们观察到CD8阳性患者和人类白细胞抗原II类表达较高的患者总体生存率（OS）更好。单因素分析确定分期、p16状态、体重指数、CONUT评分和CD8表达与OS显著相关。多因素分析中，分期、体重指数和CONUT评分仍然是OS的显著预测因素。基于分期、p16状态、体重指数、CONUT评分和CD8表达建立了一个风险评分系统。患者被分为低风险和高风险组，低风险组的生存率明显更好。
结合临床、营养和免疫因素的综合风险评分可以改善OPC患者治疗结果的预测。这种风险分层可能有助于制定个性化治疗方案并提高OS率。
