Treatment‑related lymphopenia predicts long‑term survival in locally advanced head and neck cancer: Post‑Hoc analysis of a randomized phase III trial
Treatment‑related ALC decline is an independent adverse prognostic factor in LA‑HNSCC.
The study evaluated the prognostic value of treatment‑related decline in peripheral absolute lymphocyte count (ALC) in 222 patients with locally advanced head and neck squamous cell carcinoma (LA‑HNSCC) after preoperative radiation therapy (RT) with or without chemotherapy. ALCs were measured before, during, and after RT. An ALC decline >0.74×10⁹ L was independently associated with poorer overall survival (OS) and progression‑free survival (PFS). A nomogram incorporating T stage, N stage, ALC decline, and neutrophil‑to‑albumin ratio (NAR) yielded a C‑index of 0.66 and a 5‑year area under the curve of 0.738. Treatment‑related ALC decline is an independent adverse prognostic factor in LA‑HNSCC, and a nomogram incorporating ALC decline performs favorably in individualized survival prediction.
Identifying a simple, routinely‑measured biomarker that predicts long‑term survival can help clinicians stratify patients, tailor treatment intensity, and potentially guide the integration of newer therapies such as immunotherapy in locally advanced head and neck squamous cell carcinoma.
Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.
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