| Purpose:Systemic immune-inflammation index(SII)is significantly associated with poor survival in variety of cancers.However,SII has not yet been investigated in patients with newly diagnosed metastatic Nasopharyngeal Carcinoma(mNPC).Thus,our aim is to explore the role of SII in metastatic Nasopharyngeal Carcinoma.Methods/patients:From January 2007 to July 2015,243 patients with metastatic Nasopharyngeal carcinoma were enrolled in our Hospital.Among 243 patients,55(22.6%)patients suffered from multiple organ metastases.105 and 112 patients received two-dimensional radiotherapy(2DRT)or intensity modulated radiation therapy(IMRT)of the primary tumor,respectively.The planning and delivery of 2DRT and IMRT were applied as previous study.The median dose was 69.75 Gy(range,6-79.55 Gy)in the above 217 patients.100% patients received at least one cycle induction chemotherapy.The regimen of induction chemotherapy was platinum-based two or three drugs combination chemotherapy.84(34.6%)patients received concurrent chemoradiotherapy.As to the metastatic foci,64 patients with bone metastasis and 3 patients with distant lymph nodes were treated with local radiotherapy.Percutaneous alcohol injection therapy was applied to 4 patients with localized liver metastatic lesions.8 patients underwent radiotherapy or resection of metastatic lung lesions.Data analysis was performed using SPSS version 22 software.The relationship between SII and clinicopathologic characteristics was analyzed using χ2 test or Fisher’s exact test.Kaplan-Meier analysis and Cox regression analysis was performed to evaluate the prognostic value of SII in overall survival(OS)and progression-free survival(PFS).Heterogeneity of factors was balanced by using propensity score-matched(PSM)analysis(1:1 for high SII versus low SII).A P value of less than 0.05 was considered statistically significant.Results:The staging of mNPC were classified according to the American Joint Committee on Cancer(AJCC)and the Union for International Cancer Control(UICC),8th Edition.Of all 243 patients,the median age was 48 years(range:17-81 years),and the proportion of male(75.7%)were three times that of female(39%).Non-keratinizing undifferentiated carcinoma accounts for more than 90% of all NPC.At last follow up,178(73.3%)patients had died.The median OS and PFS for all patients was 31.5(range: 2-135)months and 19.0(range: 1-135)months,respectively.The estimated OS for 1-year,3-year and 5-year was 79.8%,43.5% and 31.5%,respectively.Optimal cutoff thresholds of SII is determined by High SII(> 930)was present in 57(23.46%)mNPC patients.High SII was associated with advanced N stage(p = 0.047)and patients without IMRT therapy(p = 0.002).No statistically significant difference was observed between SII level and gender,age at diagnosis,T classification,pathological type and ECOG score.Kaplan-Meier analysis showed that patients with high SII were associated with poor median OS(18.0m vs 36.0m,p < 0.001)and PFS(10.0m vs 22.0m,p < 0.001)in mNPC.The Cox regression analysis suggested that high SII was a prognostic factor for OS(HR 1.75,95% CI 1.22-2.52,p = 0.001)and PFS(HR 1.69,95% CI 1.22-2.35,p = 0.002).PSM analysis still confirmed that SII was an independent marker for OS(HR 1.86,95% CI 1.22-2.83,p = 0.004)and PFS(HR 1.84,95% CI 1.23-2.77,p = 0.003).Conclusions:SII is an independent prognostic biomarker for poor OS and PFS in patients with newly diagnosed mNPC and might be a promising tool for guiding treatment strategy decisions. |
PDF Full Text Request