Abstract
Purpose
This research aimed to evaluate the prognostic significance of baseline prognostic nutritional index (PNI) and lactate dehydrogenase (LDH) for the outcome of individuals diagnosed with non-metastatic nasopharyngeal carcinoma (NPC).
Methods
A retrospective analysis was conducted on data from 810 patients with non-metastatic NPC who underwent intensity-modulated radiation therapy (IMRT) with or without chemotherapy. The best cut-offs for PNI and LDH were identified by X-tile software to be 48.5 and 150, respectively. To find the independent prognostic factors for survival outcomes, univariate and multivariate regression analyses were conducted, and AUCs were used to compare their prognostic values.
Results
Multivariate analysis revealed that patients with PNI > 48.5 had better overall survival (OS) (HR: 0.502, P < 0.001), progression-free survival (PFS) (HR: 0.618, P < 0.001), and distant metastasis-free survival (DMFS) (HR: 0.637, P = 0.005). Higher LDH was associated with poorer OS (HR: 1.798, P < 0.001), PFS (HR: 1.671, P < 0.001), and DMFS (HR: 1.756, P < 0.001). The combination of low PNI and high LDH in non-metastatic NPC patients was correlated with poor OS (P < 0.001), PFS (P < 0.001), and DMFS (P < 0.001). The combination of PNI and LDH had the highest AUCs for predicting OS, PFS, and DMFS.
Conclusions
PNI and LDH might become valuable predictors of the prognosis of non-metastatic NPC patients undergoing IMRT with or without chemotherapy. Prognostic accuracy can be enhanced by combining PNI and LDH.
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Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
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Funding
This work was sponsored by National Clinical Key Specialty Construction Program and Key Clinical Specialty Discipline Construction Program of Fujian, China. This study was supported by grants from the National Clinical Key Specialty Construction Program; Fujian Provincial Clinical Research Center for Cancer Radiotherapy and Immunotherapy (grant number: 2020Y2012). This research was also supported by grant from the Fujian Provincial Natural Science Foundation of China (Grant No. 2023J011271), Fujian Provincial Health Technology Project (Grant No. 2021NA040) and Startup Fund for scientific research, Fujian Medical University (Grant No. 2022QH1153).
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Conceptualization: ZWZ Data acquisition: YXF and YYR. and ZSD Data analysis: ML and SSY and SXX and YPZ Manuscript drafting: CXZ and ZWZ Manuscript revision, formal analysis: BJC All authors have reviewed and given their approval for the final manuscript.
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Zhang, C., Zhan, Z., Fang, Y. et al. Prognostic nutritional index and serum lactate dehydrogenase predict the prognosis of nasopharyngeal carcinoma patients who received intensity-modulated radiation therapy. J Cancer Res Clin Oncol 149, 17795–17805 (2023). https://doi.org/10.1007/s00432-023-05485-5
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DOI: https://doi.org/10.1007/s00432-023-05485-5