Predictive value of prognostic nutritional index for treatment efficacy and prognosis in locally advanced esophageal squamous cell carcinoma patients treated with chemotherapy combined with immune sequential radiotherapy
10.3872/j.issn.1007-385x.2025.04.009
- VernacularTitle:PNI在局部晚期食管鳞状细胞癌患者接受化疗联合免疫序贯放疗中疗效及预后的预测价值
- Author:
Yu WANG
1
;
Zhuojun WEI
;
Lin WANG
;
Ruiqi WANG
;
Huan CHEN
;
Qi CHENG
;
Xiao LIN
;
Honglian MA
;
Yujin XU
Author Information
1. 浙江中医药大学 第二临床医学院,浙江 杭州 310053;浙江省肿瘤医院 胸部放疗科,中国科学院杭州医学研究所,浙江 杭州 310022
- Publication Type:Journal Article
- Keywords:
esophageal squamous cell carcinoma(ESCC);
prognostic nutritional index(PNI);
chemotherapy combined with immune sequential radiotherapy;
prognosis
- From:
Chinese Journal of Cancer Biotherapy
2025;32(4):405-412
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive and prognostic value of prognostic nutritional index(PNI)for patients with locally advanced esophageal squamous cell carcinoma(ESCC)undergoing induction chemotherapy combined with immune sequential radiotherapy.Methods:A retrospective analysis was conducted on clinical data from 126 locally advanced ESCC patients who had undergone induction chemotherapy combined with immune sequential radiotherapy at Zhejiang Cancer Hospital between May 2019 and August 2023.Receiver operating characteristic(ROC)curves were used to determine optimal PNI cutoff values within 1 week before induction chemoimmunotherapy,within 1 week before radiotherapy,and at 4±1 weeks after radiotherapy initiation,with subsequent patient stratification.The Kaplan-Meier method was used to generate survival curves and the log-rank test was used to compare overall survival(OS)and progression-free survival(PFS)between groups.Cox regression analysis was employed to identify factors affecting the prognosis of locally advanced ESCC patients undergoing induction chemoimmunotherapy combined with sequential radiotherapy.Results:A total of 126 locally advanced ESCC patients,118 males and 8 females,with a median age of 65 years(44-78 years)were included.The optimal critical values of PNI before induction chemoimmunotherapy,before radiotherapy and during radiotherapy identified using ROC curves were 46.2,48.3 and 37.9.The median OS and PFS were 47.3 and 28.2 months in the group with PNI≥48.3 before radiotherapy,and 18.7 and 15.2 months in the group with PNI<48.3 before radiotherapy,respectively(P<0.01,P<0.05).The median OS was not reached and the median PFS was 25.7 months in the group with PNI≥37.9 in radiotherapy,and the median OS and PFS were 17.0 and 12.5 months in the group with PNI<37.9 in radiotherapy,respectively(P<0.01,P<0.05).The median OS was not reached and the median PFS was 28.4 months in the group with elevated PNI after induction chemoimmunization;the median OS and PFS were 20.4 and 16.0 months in the group with reduced PNI(P<0.01,P<0.05).Multifactorial analysis showed that PNI in radiotherapy[HR=2.292,95%CI(1.264,4.159),P<0.05],and change in PNI after induction of chemoimmunization[HR=2.120,95%CI(1.007,4.463),P<0.05]were factors affecting OS.Conclusion:PNI during radiotherapy and changes in PNI after induction chemoimmunity correlate with patients'treatment efficacy and prognosis,and can be used as important indicators to predict the benefits of induction chemoimmunization combined with sequential radiotherapy for ESCC.
