Effects of Onodera′s prognostic nutritional index on the prognosis of locally advanced oropharyngeal squamous cell carcinoma after induction chemotherapy followed by sequential chemoradiotherapy
10.3760/cma.j.cn112271-20221009-00404
- VernacularTitle:局部晚期口咽鳞癌诱导化疗序贯放化疗后小野寺预后营养指数对预后的影响
- Author:
Yuanyuan LI
1
;
Miao WANG
;
Feng JIN
;
Weili WU
;
Jinhua LONG
;
Xiuling LUO
;
Xiuyun GONG
;
Xiaoxiao CHEN
Author Information
1. 贵州医科大学附属医院肿瘤科，贵阳 550001
- Keywords:
Prognostic nutritional index;
Oropharyngeal squamous cell carcinoma;
Human papilloma virus;
Intensity-modulated radiotherapy;
Prognosis
- From:
Chinese Journal of Radiological Medicine and Protection
2023;43(4):256-262
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of Onodera′s prognostic nutritional index (PNI) on the prognosis of locally advanced oropharyngeal squamous cell carcinoma (LA-OPSCC) after induction chemotherapy followed by sequential chemoradiotherapy.Methods:A retrospective analysis was conducted on the clinical data of 52 LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy in The Affiliated Cancer Hospital of Guizhou Medical University during 2014-2018. The PNI values of all the patients at different treatment phases were statistically analyzed, and the ROC curve was employed to determine the optimal critical value of PNI. The patients in this study were divided into a well-nourished group ( n = 27) and a poorly-nourished group ( n = 25). The Kaplan-Meier method was used for survival analysis. The Cox proportional hazards model was utilized to analyze the relationships between different nutritional status and prognosis. Clinical features and adverse reactions were compared between the two groups. Results:The PNI values decreased significantly after radiotherapy, with an optimal critical value of 42.4. The 5-year overall survival (OS) and progression-free survival (PFS) of the well-nourished group (PNI ≥ 42.4) were 62.6% and 60.9%, respectively, which were significantly higher than those (30.1% and 29.7%) of the poorly-nourished group (PNI < 42.4, χ2 = 11.12, 5.74, P < 0.05). The multivariate analysis showed that PNI was an independent prognostic factor for the OS after radiotherapy ( HR = 2.752, 95% CI: 1.095-6.917, P = 0.031). The LA-OPSCC patients aged over 60 years or those who did not respond to induction chemotherapy accounted for a higher proportion of malnutrition after chemoradiotherapy ( χ2 = 4.89, 5.05, P < 0.05). Conclusions:PNI after radiotherapy can be used as a prognostic factor in the evaluation of LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy. The LA-OPSCC patients aged over 60 years or those who do not respond to induction chemotherapy should receive more nutritional support during the chemoradiotherapy.
