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已发表论文

营养标志物对接受调强放疗的鼻咽癌患者预后预测的价值:一项倾向值分数匹配研究

 

Authors Oei RW, Ye L, Huang J, Kong F, Xu T, Shen C, Wang X, He X, Kong L, Hu C, Ying H

Received 9 February 2018

Accepted for publication 26 May 2018

Published 14 August 2018 Volume 2018:11 Pages 4857—4868

DOI https://doi.org/10.2147/OTT.S165133

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Samir Farghaly

Purpose: To investigate the prognostic value of nutritional markers for survival in nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy (IMRT), with or without chemotherapy.
Patients and methods: This retrospective study included 412 NPC patients who received IMRT-based treatment. Weight loss (WL) during treatment, hemoglobin level (Hb) and serum albumin level (Alb) before treatment were measured. The prognostic values of these markers for overall survival (OS), locoregional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were analyzed using Kaplan–Meier method and Cox proportional hazards regression analysis. Propensity score matching was performed to reduce the effect of confounders.
Results: WL, Hb and Alb were significantly correlated with each other and inflammatory markers. Adjusted Cox regression analysis showed that critical weight loss (CWL) (WL≥5%) was an independent prognostic factor for OS (HR: 2.399, 95% CI: 1.267–4.540, =0.007) and LRFS (HR: 2.041, 95% CI: 1.052–3.960, =0.035), while low pretreatment Hb was independently associated with poor DMFS (HR: 2.031, 95% CI: 1.144–3.606, P= 0.016). However, no significant correlation was found between Alb and survival in our study cohort. The prognostic value of these markers was further confirmed in the propensity-matched analysis.
Conclusion: CWL, Hb and Alb have a significant impact on survival in NPC patients undergoing IMRT. They can be utilized in combination with conventional staging system to predict the prognosis of NPC patients treated with IMRT.
Keywords: weight loss, hemoglobin, albumin, nasopharyngeal carcinoma, intensity-modulated radiotherapy, survival



Figure 1 Heatmap illustrating correlation between nutritional and inflammatory parameters...