Definitif Radyo(kemo)terapi ile Tedavi Edilen Baş Boyun Kanserli Hastalarda Sistemik İmmun-İnflamasyon İndeksinin Prognostik Etkisi

Öz

ÖZ: Amaç: Cerrahi uygulanmayıp definitif radyo(kemo)terapi ile tedavi edilen baş boyun kanserli hastalarda sistemik immun –inflamasyon indeksinin prognostik etkisinin araştırılmasıdır. Metod: Küratif yaklaşımla radyo(kemo)terapi uygulanan baş boyun kanseri tanılı yirmi dört hasta çalışmaya dahil edilmiştir. Hastalar tanı yaşı, cinsiyet, vücut kitle indeksi, evre, radyoterapi doz/fraksiyon verisi, uygulanan kemoterapiler, tedavi öncesi tam kan sayım parametreleri, tedavi öncesi sistemik immun –inflamasyon indeksi, lokal relaps, uzak hastalık, genel sağkalım (OS), and hastalıksız sağkalım (DFS) açısından retrospektif olarak incelenmiştir. Bulgular: Sistemik immun –inflamasyon indeksinin lokal ileri evre hastalarda, evre I/II olan hastalara göre daha yüksek olduğu gözlenmiştir (p=0.004). Bununla birlikte yapılan ROC analiz sonucuna göre sistemik immun –inflamasyon indeksinin lokal ileri evre hastalığı öngörmede tanısal değeri olduğu belirlenmiştir (AUC:0.867, 95% CI :0.721-1.00, p=0.002). Medyan 9 aylık takip sonunda DFS ve OS oranı sırasıyla 79% ve 90% olarak bulunmuştur. Sonuç: Sistemik immun –inflamasyon indeksi cerrahi uygulanmadan tedavi edilen baş boyun kanserli hastalarda lokal ileri evre hastalığı öngördürmektedir. Definitif radyo(kemo)terapi yönetimine katkı sağlayabilecek bir biyobelirteç olarak gözönünde bulundurulabilir.

Anahtar Kelimeler

• Head and neck carcinoma
• Radiotherapy
• Systemic immune-inflammation index

Prognostic value of systemic immune-inflammation index in head and neck carcinoma patients undergoing definitive radio(chemo)therapy

Öz

ABSTRACT Background: The aim of this study is to investigate the prognostic effect of the systemic immune-inflammation index (SII) in non-surgically managed head and neck carcinoma patients who underwent definitive radio(chemo)therapy. Methods: Twenty four patients who were all treated with radio(chemo)terapy with curative intent for head and neck cancer (HNC) were included in the study. All patients were analyzed in terms of age at diagnosis, gender, body mass index, stage, radiotherapy dose/ fraction, chemotherapy (CT), pre-treatment complete blood count parameters, the pre-treatment systemic immune-inflammation index, local relapse, distant failure, overall survival (OS), and disease-free survival (DFS). Results: SII index was observed to be higher in locally advanced patients than in stage I/II patients (p=0.004). In addition, as a result of the evaluation made with ROC (receiver operating characteristic) analysis, it was observed that the SII index had a diagnostic value in predicting locally advanced disease (AUC:0.867, 95% CI :0.721-1.00, p=0.002). DFS and OS rates were 79% and 90% at a median follow-up of 9 months. Conclusions: The systemic immune-inflammation index predicts more advanced disease in non-surgically managed head and neck cancer patients. It can be considered as a biomarker that can contribute to the management of definitive radio(chemo)therapy.

Anahtar Kelimeler

• Head and neck carcinoma
• Radiotherapy
• Systemic immune-inflammation index

Kaynakça

1. 1. Patterson RH, Fischman VG, Wasserman I, et al. Global Burden of Head and Neck Cancer: Economic Consequences, Health, and the Role of Surgery. Otolaryngol Head Neck Surg. 2020;162(3):296-303.
2. 2. Zhou Q, Su S, You W, Wang T, Ren T, Zhu L. Systemic Inflammation Response Index as a Prognostic Marker in Cancer Patients: A Systematic Review and Meta-Analysis of 38 Cohorts. Dose Response. 2021 ;19(4) :15593258211064744. 3. Li X, Zhang S, Lu J, Li C, Li N. The prognostic value of systemic immune-inflammation index in surgical esophageal cancer patients: An updated meta-analysis. Front Surg. 2022;9:922595.
3. 4. Han R, Tian Z, Jiang Y, et al. Prognostic significance of systemic immune-inflammation index and plateletalbumin-bilirubin grade in patients with pancreatic cancer undergoing radical surgery. Gland Surg 2022;11:576-87.
4. 5. Xu S, Cao S, Yu Y. High systemic immune-inflammation index is a predictor of poor prognosis in patients with nonsmall cell lung cancer and bone metastasis. J Cancer Res Ther 2021;17:1636-42.
5. 6. Nie D, Gong H, Mao X, et al. Systemic immuneinflammation index predicts prognosis in patients with epithelial ovarian cancer: A retrospective study. Gynecol Oncol 2019;152:259-64.
6. 7. Zanoni DK, Patel SG, Shah JP. Changes in the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging of Head and Neck Cancer: Rationale and Implications. Curr Oncol Rep. 2019;21(6):52.
7. 8. Chen JH, Zhai ET, Yuan YJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol. 2017;23:6261–72.
8. 9. Lolli C, Caffo O, Scarpi E, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with mCRPC treated with abiraterone. Front Pharmacol. 2016; 7:376.

9. 10. Deng C, Zhang N, Wang Y, et al. High systemic immune-inflammation index predicts poor prognosis in advanced lung adenocarcinoma patients treated with EGFR-TKIs. Medicine. 2019;98:e16875.
10. 11. Jomrich G, Gruber ES, Winkler D, et al. Systemic immune-inflammation index (SII) predicts poor survival in pancreatic cancer patients undergoing resection. J Gastrointest Surg. 2019; doi: 10.1007/s11605-019-04187
11. 12. Li Z, Qu Y, Yang Y, et al. Prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in patients with laryngeal squamous cell carcinoma. Clin Otolaryngol. 2021;46(2):395-405.
12. 13. Kubota K, Ito R, Narita N, et al. Utility of prognostic nutritional index and systemic immune-inflammation index in oral cancer treatment. BMC Cancer. 2022;22(1):368.
13. 14. Ruiz-Ranz M, Lequerica-Fernández P, Rodríguez-Santamarta T, et al. Prognostic implications of preoperative systemic inflammatory markers in oral squamous cell carcinoma, and correlations with the local immune tumor microenvironment. Front Immunol. 2022;13:941351.
14. 15. Cho U, Sung YE, Kim MS, Lee YS. Prognostic Role of Systemic Inflammatory Markers in Patients Undergoing Surgical Resection for Oral Squamous Cell Carcinoma. Biomedicines. 2022;10(6):1268.
15. 16. Boscolo-Rizzo P, D'Alessandro A, Polesel J, et al. Different inflammatory blood markers correlate with specific outcomes in incident HPV-negative head and neck squamous cell carcinoma: a retrospective cohort study. BMC Cancer. 2022;22(1):243.
16. 17. Lu Z, Yan W, Liang J, et al. Nomogram Based on Systemic Immune-Inflammation Index to Predict Survival of Tongue Cancer Patients Who Underwent Cervical Dissection. Front Oncol. 2020;10:341. 18. Wang YT, Kuo LT, Weng HH, et al. Systemic Immun e-Inflammation Index as a Predictor for Head and Neck Cancer Prognosis: A Meta-Analysis. Front Oncol. 2022;12:899518.
17. 19. Lo WC, Chang CM, Wu CY, et al. A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation. BMC Cancer. 2022;22(1):615.
18. 20. Zeng Z, Xu S, Wang D, Qin G. Prognostic significance of systemic immune-inflammation index in patients with nasopharyngeal carcinoma: a meta-analysis. Syst Rev. 2022;11(1):247.