Association of body composition and systemic inflammation for patients with locally advanced cervical cancer following concurrent chemoradiotherapy

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-09-09 Epub Date: 2024-06-03 DOI:10.4274/dir.2024.242751

Juan Li, Cuili Niu, Ling Zhang, Yanmin Mu, Xiuyin Gui

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引用次数: 0

Abstract

Purpose: Systemic inflammation and body composition are associated with survival outcomes of cancer patients. This study aimed to examine the combined prognostic value of systemic inflammatory markers and body composition parameters in patients with locally advanced cervical cancer (LACC).

Methods: Patients who underwent concurrent chemoradiotherapy (CCRT) for LACC at a tertiary referral teaching hospital between January 2010 and January 2018 were enrolled. A predictive model was established based on systemic immune-inflammation index (SII) and computer tomography-derived visceral fat-to-muscle ratio (vFMR). Overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan-Meier method and Cox regression models. The model performance was assessed using discrimination, calibration, and clinical usefulness.

Results: In total, 212 patients were enrolled. The SII and vFMR were closely related, and both independently predicted survival (P < 0.05). A predictive model was established based on the above biomarkers and included three subgroups: high-risk [both high SII (>828) and high vFMR (>1.1)], middle-risk (either high SII or high vFMR), and low-risk (neither high SII nor high vFMR). The 3-year OS (PFS) rates for low-, middle-, and high-risk patients were 90.5% (86.0%), 73.9% (58.4%), and 46.8% (36.1%), respectively (P < 0.05). This model demonstrated satisfactory predictive accuracy (area under the curve values for predicting 3-year OS and PFS were 0.704 and 0.718, respectively), good fit (Hosmer-Lemeshow tests: P > 0.05), and clinical usefulness.

Conclusion: Systemic inflammatory markers combined with body composition parameters could independently predict the prognosis of patients with LACC, highlighting the utilization of commonly collected indicators in decision-making processes.

Clinical significance: The SII and vFMR, as well as their composite indices, were promising prognostic factors in patients with LACC who received definitive CCRT. Future studies are needed to explore novel therapies to improve the outcomes in high-risk patients.

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同时接受放化疗的局部晚期宫颈癌患者的身体成分与全身炎症的关系。

目的：全身炎症和身体成分与癌症患者的生存结果有关。本研究旨在探讨局部晚期宫颈癌（LACC）患者全身炎症标志物和身体成分参数的综合预后价值：纳入2010年1月至2018年1月期间在一家三级转诊教学医院接受同期放化疗（CCRT）治疗的LACC患者。根据全身免疫炎症指数（SII）和计算机断层扫描得出的内脏脂肪肌肉比（vFMR）建立了一个预测模型。采用 Kaplan-Meier 法和 Cox 回归模型评估了总生存期（OS）和无进展生存期（PFS）。通过判别、校准和临床实用性评估了模型的性能：共有 212 名患者入选。SII和vFMR密切相关，两者都能独立预测生存率（P<0.05）。根据上述生物标志物建立的预测模型包括三个亚组：高危组（同时具有高 SII（>828）和高 vFMR（>1.1））、中危组（高 SII 或高 vFMR）和低危组（既无高 SII 也无高 vFMR）。低危、中危和高危患者的 3 年 OS（PFS）率分别为 90.5%（86.0%）、73.9%（58.4%）和 46.8%（36.1%）（P < 0.05）。该模型具有令人满意的预测准确性（预测 3 年 OS 和 PFS 的曲线下面积值分别为 0.704 和 0.718）、良好的拟合度（Hosmer-Lemeshow 检验：P > 0.05）和临床实用性：结论：全身炎症标志物与身体成分参数相结合可独立预测LACC患者的预后，突出了在决策过程中对常用指标的利用：临床意义：SII和vFMR以及它们的综合指数是接受明确CCRT治疗的LACC患者有希望的预后因素。未来的研究需要探索新型疗法，以改善高危患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.