Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal Carcinoma

Rong Zhao,1 Zhongguo Liang,1 Kaihua Chen,1 Xiaodong Zhu1– 3 1Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China; 2Affiliated Wu-Ming Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Key Labo...

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Main Authors: Zhao R, Liang Z, Chen K, Zhu X
Format: Article
Language:English
Published: Dove Medical Press 2022-05-01
Series:Journal of Inflammation Research
Subjects:
Online Access:https://www.dovepress.com/nomogram-based-on-inflammatory-biomarkers-and-nutritional-indicators-f-peer-reviewed-fulltext-article-JIR
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author Zhao R
Liang Z
Chen K
Zhu X
author_facet Zhao R
Liang Z
Chen K
Zhu X
author_sort Zhao R
collection DOAJ
description Rong Zhao,1 Zhongguo Liang,1 Kaihua Chen,1 Xiaodong Zhu1– 3 1Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China; 2Affiliated Wu-Ming Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education/Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi, People’s Republic of ChinaCorrespondence: Xiaodong Zhu, Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China, Tel +86 13978873616, Email zhuxdonggxmu@126.comPurpose: To establish and validate a nomogram to predict overall survival in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) based on inflammatory biomarkers and nutritional indicators.Patients and Methods: A total of 1304 patients who underwent concurrent chemoradiotherapy (CCRT) with or without induction chemotherapy (IC) or adjuvant chemotherapy (AC) were included in the study. The prognosis factors of overall survival (OS) were selected by Cox regression analysis to establish the nomogram. Concordance index (C-index), calibration curves, decision curve analysis (DCA) and Kaplan–Meier curves were used to evaluate the nomogram.Results: Using multivariate Cox analysis of clinically important variables, the following variables were incorporated in the prediction of OS: age, gender, T stage, N stage, pre-treatment plasma Epstein–Barr virus (EBV) DNA, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), lactic dehydrogenase-to-albumin ratio (LAR) and prognostic nutritional index (PNI). The discriminative ability, clinical usefulness and calibration of the nomogram revealed good predictive ability as indicated by the C-index (0.717 in nomogram and 0.602 in the 8th AJCC staging system), decision curves, calibration curves and K-M curves.Conclusion: Inflammatory biomarkers and nutritional indicators of survival for LA-NPC were selected to create a nomogram predicting OS. The proposed nomogram resulted in more accurate prognostic prediction than 8th AJCC staging system.Keywords: locoregionally advanced nasopharyngeal carcinoma, inflammatory biomarker, nutritional indicator, nomogram, overall survival
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spelling doaj.art-0ddd0e725d2b45dc9873330ab70247c92022-12-22T00:34:53ZengDove Medical PressJournal of Inflammation Research1178-70312022-05-01Volume 152971298175319Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal CarcinomaZhao RLiang ZChen KZhu XRong Zhao,1 Zhongguo Liang,1 Kaihua Chen,1 Xiaodong Zhu1– 3 1Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China; 2Affiliated Wu-Ming Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education/Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi, People’s Republic of ChinaCorrespondence: Xiaodong Zhu, Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China, Tel +86 13978873616, Email zhuxdonggxmu@126.comPurpose: To establish and validate a nomogram to predict overall survival in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) based on inflammatory biomarkers and nutritional indicators.Patients and Methods: A total of 1304 patients who underwent concurrent chemoradiotherapy (CCRT) with or without induction chemotherapy (IC) or adjuvant chemotherapy (AC) were included in the study. The prognosis factors of overall survival (OS) were selected by Cox regression analysis to establish the nomogram. Concordance index (C-index), calibration curves, decision curve analysis (DCA) and Kaplan–Meier curves were used to evaluate the nomogram.Results: Using multivariate Cox analysis of clinically important variables, the following variables were incorporated in the prediction of OS: age, gender, T stage, N stage, pre-treatment plasma Epstein–Barr virus (EBV) DNA, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), lactic dehydrogenase-to-albumin ratio (LAR) and prognostic nutritional index (PNI). The discriminative ability, clinical usefulness and calibration of the nomogram revealed good predictive ability as indicated by the C-index (0.717 in nomogram and 0.602 in the 8th AJCC staging system), decision curves, calibration curves and K-M curves.Conclusion: Inflammatory biomarkers and nutritional indicators of survival for LA-NPC were selected to create a nomogram predicting OS. The proposed nomogram resulted in more accurate prognostic prediction than 8th AJCC staging system.Keywords: locoregionally advanced nasopharyngeal carcinoma, inflammatory biomarker, nutritional indicator, nomogram, overall survivalhttps://www.dovepress.com/nomogram-based-on-inflammatory-biomarkers-and-nutritional-indicators-f-peer-reviewed-fulltext-article-JIRlocoregionally advanced nasopharyngeal carcinomainflammatory biomarkernutritional indicatornomogramoverall survival
spellingShingle Zhao R
Liang Z
Chen K
Zhu X
Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal Carcinoma
Journal of Inflammation Research
locoregionally advanced nasopharyngeal carcinoma
inflammatory biomarker
nutritional indicator
nomogram
overall survival
title Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal Carcinoma
title_full Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal Carcinoma
title_fullStr Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal Carcinoma
title_full_unstemmed Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal Carcinoma
title_short Nomogram Based on Inflammatory Biomarkers and Nutritional Indicators for Predicting Overall Survival in Locoregionally Advanced Nasopharyngeal Carcinoma
title_sort nomogram based on inflammatory biomarkers and nutritional indicators for predicting overall survival in locoregionally advanced nasopharyngeal carcinoma
topic locoregionally advanced nasopharyngeal carcinoma
inflammatory biomarker
nutritional indicator
nomogram
overall survival
url https://www.dovepress.com/nomogram-based-on-inflammatory-biomarkers-and-nutritional-indicators-f-peer-reviewed-fulltext-article-JIR
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