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| The predictive value of controlling nutritional status combined with inflammatory markers for immune response in esophageal cancer |
| 1Wei Shuang,2Zhang Yuhong,3Sun Hongfu |
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The 3rd Department of Oncology Gaomi People?? s Hospital Weifang 261500 Shandong China
2Outpatient Department of Chronic
Disease Gaomi People?? s Hospital Weifang 261500 Shandong China
3Department of Radiation Oncology Shandong Cancer Hospital
and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan 250000 Shandong China |
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Abstract Objective To explore the controlling nutritional status CONUT and systemic immune - inflammatory index SII
neutrophil-lymphocyte ratio NLR and platelet-lymphocyte ratio ratio PLR in predicting the efficacy of immunotherapy in patients
with locally advanced or metastatic esophageal squamous cell carcinoma and the predictive efficacy of combining the above four
indicators. Method Patients with esophageal squamous cell carcinoma treated with immune combined chemotherapy or
chemoradiotherapy in Cancer Hospital of Shandong First Medical University and Gaomi People 's Hospital from January 2018 to
December 2021 were retrospectively analyzed. The hematological examination results of the patients within 1 week before treatment were
collected and the CONUT score SII NLR and PLR values of the patients were calculated. The dependent receiver operating
characteristic curve ROC curve was drawn based on one-year overall survival and the best cut-off values of CONUT SII NLR and
PLR were calculated. The primary end point was overall survival OS and the secondary end points were progression-free survival
PFS and objective response rate ORR . Result A total of 335 patients were enrolled. According to the ROC curve the cut-off
values of CONUT SII NLR and PLR were 2. 5 749. 69 2. 795 and 202. 975 respectively. The median OS was 27. 3 22. 9-31. 7
months in the low COUNT group and 23. 3 16. 29-30. 25 months in the high COUNT group P < 0. 001 . The median PFS was 10. 9
9. 96-11. 84 months in the low count group and 7. 6 6. 51-8. 63 months in the high count group P = 0. 001 . The median OS of
the low SII group and the high SII group were 27. 9 25. 12 - 30. 68 months and 17. 9 16. 99 - 18. 81 months P < 0. 001
respectively. The median PFS of the low SII group and the high SII group were 11. 6 10. 69-12. 51 months and 7. 5 (6. 56-8. 44) months P < 0. 001 respectively. The median OS of the low NLR group and the high NLR group were 28. 37 25. 25-31. 49 months
and 18. 6 16. 20-21. 0 months respectively P = 0. 016 . The PFS was 10. 93 9. 96-11. 90 months and 7. 53 6. 80-8. 26
months respectively P < 0. 001 . The median OS of the low PLR group and the high PLR group were 27. 5 23. 7-31. 3 and 21. 0
14. 3-27. 7 months respectively P = 0. 007 and the median PFS were 10. 9 9. 9 - 11. 9 and 8. 3 7. 5 - 9. 2 months
respectively P < 0. 001 . The combined prediction efficiency of the four indicators was higher than that of the single CONUT score.
Conclusion For patients with locally advanced or metastatic esophageal squamous cell carcinoma treated with immunotherapy patients
with low CONUT score before treatment have better OS and PFS than those with high CONUT score and the predictive value of
combined inflammation indicators is better.
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