Prognostic significance of the novel nutrition-inflammation marker of lymphocyte–C-reactive protein ratio in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy

Abstract

BackgroundRecent studies indicate that the novel lymphocyte–C-reactive protein ratio (LCR) is strongly associated with the survival of various tumors, but its prognostic value in nasopharyngeal carcinoma (NPC) is understudied. This study aimed to explore the relationship between LCR and overall survival (OS) in NPC and develop a predictive model.MethodsA total of 841 NPC patients who received concurrent chemoradiotherapy (CCRT) between January 2010 and December 2014 were retrospectively enrolled and randomly divided into a training cohort (n = 589) and a validation cohort (n = 252), and 122 patients between January 2015 and March 2015 were included as an additional validation cohort. Univariate and multivariate Cox analyses were performed to identify variables associated with OS and construct a predictive nomogram. The predictive accuracy of the nomogram was evaluated and independently validated.ResultsThe LCR score differentiated NPC patients into two groups with distinct prognoses (HR = 0.53; 95% CI: 0.32–0.89, P = 0.014). Multivariate analysis showed that age, T stage, N stage, EBV-DNA status, and LCR score were independently associated with OS, and a predictive nomogram was developed. The nomogram had a good performance for the prediction of OS [C-index = 0.770 (95% CI: 0.675–0.864)]. and outperformed the traditional staging system [C-index = 0.589 (95% CI: 0.385–0.792)]. The results were internally and additionally validated using independent cohorts.ConclusionThe pretreatment LCR could independently predict the overall survival in NPC patients. A novel LCR-based prognostic model of an easy-to-use nomogram was established, and it outperformed the conventional staging system in terms of predictive power. Further external verification remains necessary.

Prognostic significance of platelet‑to‑albumin ratio in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: a retrospective study of 858 cases

“…Additionally, the age, N stage, and T stage were other independent prognostic indicators correlated with OS for NPC patients treated with CCRT. These results are consistent with previous research results [ 18 , 43 ]. Therefore, we combined these independent factors with the simplified, affordable, and non-invasive serum markers to develop a nomogram to predict OS in NPC patients, which might offer a potential guide for individual clinical care.…”

“…Nutrition and inflammation, pivotal in cancer initiation and progression [ 9 , 10 ], have driven investigations into composite biomarkers that integrate both aspects. Among these are the lymphocyte-C-reactive protein ratio (LCR), Controlling Nutritional Status (CONUT), prognostic nutritional index (PNI), Glasgow prognostic score (GPS), systemic immune-inflammation index (SII), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR), which have gained traction in numerous cancers, including NPC [ 11 – 18 ]. Despite this, the relationship between pretreatment PAR and survival in NPC patients, particularly those undergoing CCRT, remains poorly understood.…”

Significance of Pre-Treatment CALLY Score Combined with EBV-DNA Levels for Prognostication in Non-Metastatic Nasopharyngeal Cancer Patients: A Clinical Perspective

“…Recently, several immune-inflammatory or nutritional prognostic indexes, including lymphocyte-to-C-reactive protein ratio (LCR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), CONUT score, and PNI, have been generated and implemented in various cancers, including NPC. 10 , 12 , 29–31 The CALLY, serving as indicators of inflammatory response, nutritional status, and immune condition, has recently been proposed for predicting the prognosis of several cancers. 15–19 In clinical practice, the CALLY index could serve as a stratification tool to identify patients who may benefit from more aggressive or personalized therapeutic interventions.…”