1Department of Clinical Nutrition, Affiliated Hospital of Jiangnan University, Wuxi 214062, China; 2Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, China
Abstract：Objective To assess the role of Glasgow prognostic score (GPS) in the prognostic evaluation of nasopharyngeal carcinoma patients. Methods Clinical data of 129 nasopharyngeal carcinoma patients who received radical radiotherapy in Affiliated Hospital of Jiangnan University from January 2012 to December 2013 were retrospectively analyzed. Clinicopathological characteristics of the patients were collected, including gender, age, TNM staging, pathological type and treatment regimen, etc. The GPS before and at 3 months after radiotherapy were calculated. The survival curve was drawn by the Kaplan-Meier method. Cox regression model was used for analysis of prognostic factors. The area under the receiver operating characteristic (ROC) curve (AUC) was utilized to evaluate the predictive capability of clinical parameters on prognosis. Results With a median follow-up of 89.0 months (range:5.1-104.6 months), the 5-year progression-free survival (PFS) of 129 patients was 79.8% and 84.5% for the 5-year overall survival (OS). At 3 months after radiotherapy, the 5-year PFS were 85.6%, 61.1% and 33.3% in the GPS 0, 1 and 2 groups, and 90.4%, 66.7% and 33.3% for the 5-year OS, respectively (all P<0.01). At 3 months after radiotherapy,the GPS, clinical staging (Ⅰ-Ⅲ vs. ⅣA) and concurrent chemotherapy were significantly correlated with PFS and OS (all P<0.01). ROC curve showed that at 3 months after radiotherapy, the AUC values of GPS, clinical staging and two combined in predicting OS were 0.694, 0.815 and 0.860, respectively. Conclusions At 3 months after radiotherapy, higher GPS is an independent poor prognostic factor for nasopharyngeal carcinoma patients. The combination of GPS and clinical staging yields high accuracy in the prognostic evaluation of nasopharyngeal carcinoma patients.
Wu Ping,Du Renjia,Yu Yun et al. The role of Glasgow prognostic score in prognostic evaluation of nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2021, 30(12): 1233-1237.
[1] 顾伟国,余锋,毛巧,等. 外周血炎症指标对99例复发转移鼻咽癌预后因素分析[J]. 中华肿瘤防治杂志,2019, 26(13):946-951. DOI:10.16073/j.cnki.cjcpt.2019.13.008. Gu WG,Yu F,Miao Q, et al. Prognostic analysis of peripherl blood inflammatory markers for 99 cases of recurrence and metastasis of nasopharyngeal carcinoma[J]. Chin J Cancer Pre Treat, 2019, 26(13):946-951. DOI:10.16073/j.cnki.cjcpt.2019.13.008. [2] Coussens LM, Werb Z. Inflammation and cancer[J]. Nature, 2002, 420(6917):860-867. DOI:10.1038/nature01322. [3] 李晓惠,徐冰清,高劲,等. 初诊鼻咽癌患者血清C反应蛋白检测临床意义分析[J]. 中华肿瘤防治杂志,2016, 23(11):727-731,738. Li XH,Xu BQ,Gao J, et al. Prospective analysis of the pre-treatment C-reactive protein in patients with nasopharyngeal carcinoma[J]. Chin J Cancer Pre Treat, 2016, 23(11):727-721, 738. DOI:10.16073/j.cnki.cjcpt.2016.11.007. [4] Stenman M, Laurell A, Lindskog M. Prognostic significance of serum albumin in patients with metastatic renal cell carcinoma[J]. Med Oncol, 2014, 31(3):841. DOI:10.1007/s12032-014-0841-7. [5] Martinez-Outschoorn UE, Peiris-Pagés M, Pestell RG, et al. Cancer metabolism:a therapeutic perspective[J]. Nat Rev Clin Oncol, 2017, 14(2):113. DOI:10.1038/nrclinonc.2017.1. [6] 崔瑶,李剑,刘明月,等. 格拉斯哥预后评分对食管胃结合部腺癌患者预后的的预测价值[J]. 中华胃肠外科杂志,2016, 19(1):54-57. DOI:10.3760/cma.j.issn.1671-0274.2016.01.012. Cui Y,Li J,Liu MY, et al. Value of Glasgow prognostic score in patients with adenocarcinoma of esophagogastric junction[J]. Chin J Gastrointest Surg, 2016,1(9):54-57. DOI:10.3760/cma.j.issn.1671-0274.2016.01.012. [7] Nie D, Zhang L, Wang C, et al. A high Glasgow prognostic score (GPS) or modified Glasgow prognostic score (mGPS) predicts poor prognosis in gynecologic cancers:a systematic review and meta-analysis[J]. Arch Gynecol Obstet, 2020, 301(6):1543-1551. DOI:10.1007/s00404-020-05581-8. [8] Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer[J]. Cell, 2010, 140(6):883-899. DOI:10.1016/j.cell.2010.01.025. [9] Prado CM, Purcell SA, Laviano A. Nutrition interventions to treat low muscle mass in cancer[J]. J Cachexia Sarcopenia Muscle, 2020, 11(2):366-380. DOI:10.1002/jcsm.12525. [10] Fang Y, Xu C, Wu P, et al. Prognostic role of C-reactive protein in patients with nasopharyngeal carcinoma:A meta-analysis and literature review[J]. Medicine (Baltimore), 2017, 96(45):e8463. DOI:10.1097/MD.0000000000008463. [11] Diakos CI, Charles KA, McMillan DC, et al. Cancer-related inflammation and treatment effectiveness[J]. Lancet Oncol, 2014, 15(11):e493-503. DOI:10.1016/S1470-2045(14)70263-3. [12] 魏学燕,韩光,吴媛,等. 局部晚期鼻咽癌患者营养状况及其与预后相关性分析[J]. 中国肿瘤临床,2020, 47(6):282-288. DOI:10.3969/j.issn.1000-8179.2020.06.271. Wei XY,Han G,Wu Y, et al. Nutritional stasus and its relationship with prognosis in patients with locally advanced nasopharyngeal carcinoma[J]. Chin J Clin Oncol, 2020, 47(6):282-288. DOI:10.3969/j.jssn.1000-8179.2020.06.271. [13] Forrest LM, McMillan DC, McArdle CS, et al. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer[J]. Br J Cancer, 2003, 89(6):1028-1030. DOI:10.1038/sj.bjc.6601242. [14] Forrest LM, McMillan DC, McArdle CS, et al.comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer[J]. Br J Cancer, 2004, 90(9):1704-1706. DOI:10.1038/sj.bjc.6601789. [15] Proctor MJ, Morrison DS, Talwar D, et al. An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site:a glasgow inflammation outcome study[J]. Br J Cancer, 2011, 104(4):726-734. DOI:10.1038/sj.bjc.6606087. [16] 崔瑶,李剑,曹养辉,等. 高敏感格拉斯哥评分对进展期胃癌患者新辅助化疗疗效和预后的预测作用[J]. 中华肿瘤杂志,2017, 39(3):195-200. DOI:10.3760/cma.j.issn.0253-3766.2017.03.007. Cui Y, Li J, Cao YH, et al. Predictive and Prognostic significance of high-sensitivity modified Glasgow Prognostic Score (HS-mGPS) in advanced gastric cancer patients treated with neoadjuvant chemotherapy[J]. Chin J Oncol, 2017, 39(3):195-200. DOI:10.3760/cma.j.issn.0253-3766.2017.03.007. [17] Lee SC, Huh JW, Lee WY, et al. Prognostic value of serum inflammatory markers in colorectal cancer[J]. Int J Colorectal Dis, 2020, 35(7):1211-1219. DOI:10.1007/s00384-020-03591-1. [18] Jin J, Hu K, Zhou Y, et al. Prognostic value of the Glasgow prognostic score in lung cancer:evidence from 10studies[J]. Int J Biol Markers, 2018, 33(2):201-207. DOI:10.5301/ijbm.5000308. [19] Chen C, Sun P, Dai QS, et al. The Glasgow prognostic score predicts poor survival in cisplatin-based treated patients with metastatic nasopharyngeal carcinoma[J/OL]. PLoS One, 2014, 9(11):e112581. DOI:10.1371/journal.pone.0112581. [20] Li XH, Chang H, Xu BQ, et al. An inflammatory biomarker-based nomogram to predict prognosis of patients with nasopharyngeal carcinoma:an analysis of a prospective study[J]. Cancer Med, 2017, 6(1):310-319. DOI:10.1002/cam4.947. [21] Huang JF, Sun RJ, Jiang WJ, et al. Systematic nutrition management for locally advanced nasopharyngeal carcinoma patients undergoing radiotherapy[J]. Onco Targets Ther, 2019, 12:8379-8386. DOI:10.2147/OTT. S213789. [22] 金子良,窦晓坛,张丽珍. 放疗前外周血中性粒细胞和淋巴细胞比值与鼻咽癌预后的相关研究[J]. 中国肿瘤临床与康复,2020, 27(2):176-179. DOI:10.13455/j.cnki.cjcor.2020.02.12. Jin ZL, Dou XT, Zhang LZ. Relationship between neutrophil to lymphocyte ratio in peripheral blood and prognosis in patients with nasopharyngeal cancer before radiotherapy[J]. Chin J Clin Oncol Rehabilit, 2020, 27(2):176-179. DOI:10.13455/j.cnki.cjcor.2020.02.12.
2021, Vol. 30 
