中国耳鼻咽喉头颈外科2025，Vol.32Issue(11)：693-699,7.DOI:10.16066/j.1672-7002.2025.11.003
局部晚期鼻咽癌基于TPF方案诱导化疗和同步放化疗前泛免疫炎症值的预后价值
The prognostic value of pan-immune-inflammation value before TPF induction chemotherapy combined with concurrent chemoradiotherapy locally advanced nasopharyngeal carcinoma
摘要
Abstract
OBJECTIVE To explore the survival outcomes of patients with locally advanced nasopharyngeal carcinoma who received induction chemotherapy with the docetaxel-cisplatin-5-fluorouracil(TPF)regimen combined with concurrent chemoradiotherapy(CCRT),and to clarify the prognostic value of pan-immune-inflammation value(PIV).METHODS A retrospective study was conducted on 128 patients with stage III-IVA(N2-N3).All patients received induction chemotherapy based on the TPF regimen and CCRT based on intensity-modulated radiotherapy at Huanggang Central Hospital from January 2018 to August 2020.The time-dependent receiver operating characteristic(time-ROC)curve was applied to evaluate the predictive ability of PIV for mortality and determine the optimal cut-off value.Kaplan-Meier and Cox proportional hazards regression analyses were used to analyze 5-year overall survival,progression-free survival(PFS),and distant metastasis-free survival(DMFS).RESULTS The median follow-up time was 60.0(range:11.0-60.0)months,with a total of 33 cases(25.78%)of death,39 cases(30.47%)of progression,and 22 cases(17.19%)of distant metastasis.According to the time-ROC curve statistics,the area under the curve of PIV for predicting 1-year OS[0.96(95%CI:0.89-1.00)]was the highest,and the optimal cut-off value was 618.17.All patients were divided into the low PIV group(<618.17)and the high PIV group(≥618.17).Compared with patients with low PIV,patients with high PIV had higher 5-year mortality rate(7.69%vs.54.00%),5-year progression rate(12.82%vs.58.00%),and 5-year distant metastasis rate(5.13%vs.36.00%),as well as shorter median OS time(60.0 months vs.56.50 months,Log Rank χ2=39.479,P<0.001),median PFS time(60.0 months vs.35.50 months,Log Rank χ2=37.966,P<0.001),and median DMFS time(60.0 months vs.44.0 months,Log Rank χ2=24.879,P<0.001).After screening prognostic variables through Cox proportional hazards regression,a nomogram was established for predicting death prognosis based on four variables:karnofsky performance status,N stage,EBV-DNA,and PIV.The area under the curve of the nomogram model for predicting the risk of death was 0.88(95%CI:0.81-0.95),and the clinical decision curve analysis showed that when the threshold probability was 0.1-0.7,it proved that this model could bring net clinical benefits to patients.CONCLUSION Pre-treatment PIV can serve as an independent prognostic biomarker for patients with stage N2-N3 locally advanced nasopharyngeal carcinoma undergoing TPF regimen induction chemotherapy and CCRT treatment,with a higher PIV indicating a poor prognosis for the patients.关键词
鼻咽癌/预后/泛免疫炎症值/诱导化疗联合同步放化疗Key words
Nasopharyngeal Carcinoma/Prognosis/pan-immune-inflammation value/induction chemotherapy combined with concurrent chemoradiotherapy引用本文复制引用
吴晓峰,王水斌,万龙,赵建红,杨志勇..局部晚期鼻咽癌基于TPF方案诱导化疗和同步放化疗前泛免疫炎症值的预后价值[J].中国耳鼻咽喉头颈外科,2025,32(11):693-699,7.基金项目
湖北省卫生健康科技项目(HGYYMS09) （HGYYMS09）
