Prediction of pathological remission of head and neck squamous cell carcinoma patients after neoadjuvant immunochemotherapy and construction of clinical model based on clinical features and inflammatory markers
10.3760/cma.j.cn115330-20231226-00331
- VernacularTitle:基于临床特征及炎症标志物预测头颈部鳞癌患者新辅助免疫化疗后病理缓解情况及临床模型构建
- Author:
Qiaohong LIN
1
;
Shida YAN
;
Xing ZHANG
;
Shuwei CHEN
;
Xiyuan LI
;
Ying ZHANG
;
Shiting ZHANG
;
Ming SONG
Author Information
1. 中山大学肿瘤防治中心 广东省肿瘤临床研究中心华南肿瘤国家重点实验室 广东省鼻咽癌诊疗重点实验室，广州 510060
- Keywords:
Head and neck neoplasms;
Carcinoma, squamous cell;
Neoadjuvant immunochemotherapy;
HPV infection;
Inflammatory indicators;
Nomogram model
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2024;59(4):357-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the potential clinical biological factors influencing the major pathological response (MPR) to neoadjuvant immunochemotherapy in patients with resectable head and neck squamous cell carcinoma (HNSCC).Methods:This retrospective study enrolled patients with resectable HNSCC who underwent neoadjuvant immunochemotherapy at Sun Yat-sen University Cancer Center from June 1, 2019 to December 31, 2021. Binary logistic regression was used to analyze the correlation between clinical characteristics, inflammatory markers and MPR, and a nomogram model was constructed. The calibration curve and decision curve analysis were used to verify the predictive ability and accuracy of the nomogram model.Results:A total of 173 patients were included in the study, with 141 males and 32 females, aged from 22 to 83 years. After pathological assessment, the patients were divided into two groups: MPR group (108 cases) and non MPR group (65 cases). Logistics regression analysis indicated that the patients with HPV+oropharyngeal cancer, partial response or complete response by imaging assessment, low pre-treatment platelet/lymphocyte ratio, low pre-treatment C reactive protein/albumin ratio and lower pre-and post-treatment C reactive protein/albumin ratio difference were more likely to have MPR (all P<0.05). Nomogram model was constructed based on the above factors, with a C-index of 0.826 (95% CI: 0.760-0.892), and the calibration curve and decision curve analysis confirmed the prediction accuracy of the model. Conclusion:This study shows that many factors are related to MPR of patients with resectable HNSCC receiving neoadjuvant immunochemotherapy and the constructed nomogram model helps to develop personalized treatment strategies for the patients.
