Prognostic significance of immune-inflammatory and nutritional indicators in locoregionally advanced nasopharyngeal carcinoma

Cancer research · Nasopharyngeal carcinoma

High C2 (cut‑off > –0.242) predicted better overall survival in LA‑NPC patients.

This retrospective analysis of 267 patients with locoregionally advanced nasopharyngeal carcinoma (LA‑NPC) used principal component analysis to derive an immune‑inflammatory index (C1) and a nutritional index (C2). A cut‑off for C2 of –0.242 distinguished high‑ and low‑risk groups; high C2 was independently associated with improved overall survival (OS), progression‑free survival (PFS), distant metastasis‑free survival (DMFS) and locoregional relapse‑free survival (LRRFS). Age, T stage, lactate dehydrogenase (LDH) level and C2 emerged as independent prognostic factors. A nomogram incorporating these variables achieved a concordance index of 0.738 and was internally validated with a bias‑corrected C‑index of 0.718. Patients classified as high risk derived greater overall survival benefit from induction chemotherapy plus radiotherapy or concurrent chemoradiotherapy (RT/CCRT) compared with RT/CCRT alone, whereas low‑risk patients had similar outcomes with either strategy.

C2, an integrated nutritional score, provides a reproducible, non‑invasive prognostic marker that can guide personalized treatment decisions, particularly regarding the use of induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma.

Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.

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