Serum immune parameters as predictors for treatment outcomes in cervical cancer treated with concurrent chemo-radiotherapy.
10.1097/CM9.0000000000003553
- Author:
Lihua CHEN
1
;
Weilin CHEN
2
;
Yingying LIN
3
;
Xinran LI
1
;
Yu GU
1
;
Chen LI
1
;
Yuncan ZHOU
4
;
Ke HU
4
;
Fuquan ZHANG
4
;
Yang XIANG
1
Author Information
1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
2. Department of Radiation Oncology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian 363000, China.
3. Department of Healthcare, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350005, China.
4. Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
- Publication Type:Journal Article
- Keywords:
Cervical cancer;
Concurrent chemo-radiotherapy;
Immune;
Inflammatory;
Prognosis;
Serum parameters
- MeSH:
Humans;
Female;
Uterine Cervical Neoplasms/drug therapy*;
Middle Aged;
Adult;
Aged;
Chemoradiotherapy/methods*;
L-Lactate Dehydrogenase/blood*;
Treatment Outcome;
Disease-Free Survival;
Prognosis;
ROC Curve;
Biomarkers, Tumor/blood*;
Proportional Hazards Models
- From:
Chinese Medical Journal
2025;138(23):3131-3138
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Concurrent chemo-radiotherapy (CCRT) is the standard treatment for locally advanced cervical cancer (LACC), but there are still many patients who suffer tumor recurrence. However, valuable predictors of treatment outcomes remain limited. This study aimed to assess the value of the serum immune biomarkers to predict the prognosis.
METHODS:We reviewed cervical cancer patients treated with CCRT between January 2014 and May 2018 at Peking Union Medical College Hospital. The systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and lactate dehydrogenase (LDH) were calculated using blood samples. The relationship between immune markers and the treatment outcome was analyzed. The area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency. The Cox proportional hazards model and log-rank were used to predict overall survival (OS) and disease-free survival (DFS).
RESULTS:This study included 667 patients. Among them, 195 (29.2%) patients were defined as treatment failure, including 127 (19.0%) patients with pelvic failure, 94 (14.1%) distant failure, and 25 (3.7%) concurrent pelvic and distant failure. It revealed that the tumor stage, size, metastatic lymph nodes (MLNs), and serum immune biomarkers, such as SII, SIRI, and LDH, were significantly related to treatment outcomes. We demonstrated that the optimal cut-off of the SII, SIRI, and LDH were 970.4 × 10 9 /L, 1.3 × 10 9 /L, and 207.52 U/L, respectively. Importantly, this study presented that LDH level had the highest OR (OR = 4.2; 95% CI [2.3-10.8]). Furthermore, the OS and DFS for patients with pre-SII ≥970.5 × 10 9 /L were significantly worse than those with pre-SII <970.5 × 10 9 /L. Similarly, pre-SIRI ≥1.25 × 10 9 /L and pre-LDH ≥207.5 U/L were related to poor survival outcomes.
CONCLUSIONS:This study demonstrated that the baseline SII, SIRI, and LDH levels can be used to accurately and effectively predict the treatment outcomes after CCRT and long-term prognosis. Our results may offer additional prognostic information in clinical, which helps to detect the potential recurrent metastasis in time.
