Predictive Effect of Prognostic Nutritional Index on Lymph Node Regression Rate in Patients with Locally Advanced Nasopharyngeal Carcinoma Undergoing Concurrent Chemoradiotherapy.

Abstract

ObjectiveDetermining reliable predictive indicators of therapeutic efficacy for patients with nasopharyngeal carcinoma (NPC) can help select those who will benefit the most from treatment. This research assessed the predictive significance of the prognostic nutritional index (PNI) in patients with locally advanced nasopharyngeal carcinoma (LANPC) receiving concurrent chemoradiotherapy (CCRT).MethodsA retrospective analysis was performed on 128 patients with LANPC who underwent CCRT. The PNI was calculated using peripheral blood values, the optimal cut-off value of the PNI was determined using the receiver operating characteristic (ROC) curve, and the patients were categorized into low- and high-PNI groups. The Mann-Whitney U test and Pearson's chi-square test were employed to test the differences between groups. Univariate and multivariate logistic regression analyses were used to determine the predictors of a good response to CCRT.ResultsThe optimal cut-off value for PNI was 51.95. The regression rates of the cervical lymph nodes (CLNs) and total lymph nodes (TLNs) were higher in the high-PNI group compared to the low-PNI group (CLNs 78.67% and 65.91%; TLNs 78.56% and 67.60% respectively). Multivariate logistic regression showed that the PNI served as an independent predictor of CCRT efficacy in patients with LANPC.ConclusionThe PNI is a non-invasive, low-cost, and easy-to-use indicator in clinical practice for patients with LANPC undergoing CCRT. Patients with LANPC and low PNI require attention to ensure early diagnosis of residual disease and timely rescue treatment. These findings may help develop treatment strategies and clinical risk stratification.