Geriatric nutritional risk index as an independent prognostic factor in locally advanced nasopharyngeal carcinoma treated using radical concurrent chemoradiotherapy: a retrospective cohort study

作者：Qing‐Nan Tang, Hui-Zhi Qiu, Xiaoqing Sun, Shanshan Guo, Li‐Ting Liu, Yue‐Feng Wen, Sai‐Lan Liu, Haojun Xie, Yu-Jing Liang, Xue-Song Sun, Xiaoyun Li, Jin‐Jie Yan, Jin‐Hao Yang, Dong‐Xiang Wen, Ling Guo, Lin‐Quan Tang, Qiuyan Chen, Hai‐Qiang Mai · 发表于：Annals of Translational Medicine · 年份：2021 · DOI：10.21037/atm-20-6493 · 被引用次数：23 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Nutrition and Health in Aging、Head and Neck Cancer Studies

BACKGROUND: Nutritional status is a key factor influencing the prognosis of patients with cancer. The Geriatric Nutritional Risk Index (GNRI) has been used to predict mortality risk and long-term outcomes. In this study, we aimed to evaluate the predictive value of pretreatment GNRI in patients with nasopharyngeal carcinoma (NPC). METHODS: A total of 1,065 patients with biopsy-proven non-disseminated nasopharyngeal carcinoma were included. Based on a cutoff value of pretreatment GNRI, patients were divided into two groups (low ≤107.7 and high >107.7). Combining GNRI and baseline Epstein-Barr virus (EBV) DNA, all patients were further stratified into three risk groups, namely, high-risk (high EBV DNA and low GNRI), low-risk (low EBV DNA and high GNRI), and medium-risk (except the above) groups. Multivariate analyses were performed using the Cox proportional hazards model to assess the predictive value of the GNRI. RESULTS: Among the 1,065 patients, 527 (49.5%) and 538 (50.5%) were divided into low and high GNRI groups, respectively. Within a median follow-up of 83 months, patients with a high GNRI score exhibited significantly higher overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) compared to those with low GNRI scores (P<0.05). Multivariate analyses revealed that high GNRI is an independent prognostic factor for OS and PFS (hazard ratio, HR, 0.471, 95% CI, 0.270-0.822, P=0.008; HR 0.638, 95% CI, 0.433-0.941, P=0.023, respect...