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. 2022 Jun 5;22(1):615.
doi: 10.1186/s12885-022-09732-9.

A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation

Wu-Chia Lo  1   2   3 , Chih-Ming Chang  1   4 , Chia-Yun Wu  3   5 , Chen-Hsi Hsieh  3   6   7 , Pei-Wei Shueng  3   6   7 , Po-Wen Cheng  1 , Li-Jen Liao  8   9   10
Affiliations

A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation

Wu-Chia Lo et al. BMC Cancer. .

Abstract

Background: To analyze clinical characteristics in the prediction of death within 1 year in advanced oropharyngeal cancer patients treated with chemoradiation.

Methods: One hundred forty-seven advanced oropharyngeal cancer patients who underwent curative-intent chemoradiation treatment were retrospectively enrolled. The pre-treatment clinical parameters including inflammatory markers were reviewed.

Results: The 1-year death rate for all patients was 29% [95% confidence interval (CI): 23-37%]. In multivariate logistic regression analysis, hemoglobulin (Hb) < 13.5 g/dl was an independent indicator of death within 1-year [Odds ratio (OR) 5.85, 95% CI 2.17-15.75, p < 0.001]. Systemic immune inflammation (SII) ≥ 1820 was also a significant factor for prediction of death within 1 year (OR 4.78, 95% CI 1.44-15.85, p = 0.011). We further used gander, age, Hb and SII to develop a nomogram to predict death within 1 year. The c-index of the model was 0.75 (95%CI 0.66-0.83). For patients with low nomogram score (< 14) versus high nomogram score (≥ 14), the 1-year and 2-year OS rates were 91 and 71% versus 53 and 29%, respectively. (p < 0.001). A difference in the disease persistence or recurrence rate between patients with high and low nomogram score was significant (73 and 28%, respectively; p < 0.001).

Conclusions: The pre-treatment Hb < 13.5 g/dl and SII ≥ 1820 are associated with higher risks of death within 1-year in patients with advanced oropharyngeal cancers. Nomogram can aid in patient counseling and treatment modality adjustment. The development of a more effective treatment protocol for patients with high nomogram score will be essential.

Keywords: Chemoradiation; Death; Hemoglobulin; Nomogram; Oropharyngeal cancer; Survival; Systemic immune inflammation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The 1-year and 2-year OS rates for advanced oropharyngeal cancer patients with Hb ≥ 13.5 g/dl versus Hb < 13.5 g/dl were 88 and 67% versus 55 and 33%, respectively
Fig. 2
Fig. 2
The 1-year and 2-year OS rates for advanced oropharyngeal cancer patients with low SII (< 1820) versus high SII (≥ 1820) were 78 and 57% versus 30 and 9%, respectively
Fig. 3
Fig. 3
Nomogram of death within 1-year in advanced oropharyngeal cancer patients
Fig. 4
Fig. 4
The 1-year and 2-year OS rates for advanced oropharyngeal patients with low nomogram score (< 14) versus high nomogram score (≥ 14) were 91 and 71% versus 53 and 29%, respectively
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