Value of dynamic prognostic nutritional index in evaluating prognosis of locally advanced esophageal squamous cell carcinoma patients undergoing radiotherapy and chemotherapy
LIN Guishan
LUO Huachun
Abstract：Objective To investigate the clinical significance of dynamic prognostic nutrition index (PNI) in evaluating the prognosis of patients with locally advanced esophageal squamous cell carcinoma after concurrent radiotherapy and chemotherapy. Methods Data of 81 patients with locally advanced esophageal squamous cell carcinoma treated with concurrent radiotherapy and chemotherapy from April 2012 to March 2016 were collected, including gender, age, BMI, tumor location, differentiation, TNM stage, pretreatment PNI (PNI1) and post-treatment PNI (PNI2). RECIST 1. 1 standard was used to evaluate the short-term efficacy, and Kaplan Meier method and Log-rank test were used for survival analysis. Cox proportional-hazards regression model was used to analyze the factors affecting the prognosis. Results The short-term efficacy was evaluated in all 81 patients, including 24 cases of CR, 47 cases of PR and 10 cases of SD. The median progression free survival (PFS) was 22. 71 months (13. 80-45. 15 months) and the median overall survival (OS) was 27. 47 months (17. 66-57. 02 months). Univariate analysis showed that lower thoracic segment, stage Ⅳ, PNI1≤45 and PNI2≤45 were associated with short PFS and OS. Multivariate Cox proportional-hazards regression model analysis showed that stage Ⅳ and PNI1≤45 were independent risk factors for PFS and OS. There were significant differences in PFS and OS among groups with PNI＞ 45, inconsistent changes of PNI before and after treatment and those with PNI≤45 (P ＜ 0. 05). PFS and OS in PNI＞ 45 group were the best. The patients with inconsistent of PNI were divided into two groups: the PNI2 improvement group and the PNI2 deterioration group. There was no significant difference in PFS and OS between the two groups (P＞ 0. 05). Conclusion PNI is a simple, convenient and effective nutrition-immunity index, which can be used to predict the therapeutic effect of cancer in clinic. Dynamic observation of PNI before and after treatment may better predict the long-term efficacy of radiotherapy and chemotherapy for locally advanced esophageal squamous cell carcinoma.
Keywords：Esophageal squamous cell carcinomaPrognostic nutritional index (PNI)ChemoradiotherapyCox proportional-hazards regression model
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 38-43 )