Necla GÜRDAL, Yaren CERAN, Ayse KOTEK SEDEF

Definitif Radyo(kemo)terapi ile Tedavi Edilen Baş Boyun Kanserli Hastalarda Sistemik İmmun-İnflamasyon İndeksinin Prognostik Etkisi

ÖZ: Amaç: Cerrahi uygulanmayıp definitif radyo(kemo)terapi ile tedavi edilen baş boyun kanserli hastalarda sistemik immun –inflamasyon indeksinin prognostik etkisinin araştırılmasıdır. Metod: Küratif yaklaşımla radyo(kemo)terapi uygulanan baş boyun kanseri tanılı yirmi dört hasta çalışmaya dahil edilmiştir. Hastalar tanı yaşı, cinsiyet, vücut kitle indeksi, evre, radyoterapi doz/fraksiyon verisi, uygulanan kemoterapiler, tedavi öncesi tam kan sayım parametreleri, tedavi öncesi sistemik immun –inflamasyon indeksi, lokal relaps, uzak hastalık, genel sağkalım (OS), and hastalıksız sağkalım (DFS) açısından retrospektif olarak incelenmiştir. Bulgular: Sistemik immun –inflamasyon indeksinin lokal ileri evre hastalarda, evre I/II olan hastalara göre daha yüksek olduğu gözlenmiştir (p=0.004). Bununla birlikte yapılan ROC analiz sonucuna göre sistemik immun –inflamasyon indeksinin lokal ileri evre hastalığı öngörmede tanısal değeri olduğu belirlenmiştir (AUC:0.867, 95% CI :0.721-1.00, p=0.002). Medyan 9 aylık takip sonunda DFS ve OS oranı sırasıyla 79% ve 90% olarak bulunmuştur. Sonuç: Sistemik immun –inflamasyon indeksi cerrahi uygulanmadan tedavi edilen baş boyun kanserli hastalarda lokal ileri evre hastalığı öngördürmektedir. Definitif radyo(kemo)terapi yönetimine katkı sağlayabilecek bir biyobelirteç olarak gözönünde bulundurulabilir.

Anahtar Kelimeler:

Head and neck carcinoma, Radiotherapy, Systemic immune-inflammation index

Prognostic value of systemic immune-inflammation index in head and neck carcinoma patients undergoing definitive radio(chemo)therapy

ABSTRACT Background: The aim of this study is to investigate the prognostic effect of the systemic immune-inflammation index (SII) in non-surgically managed head and neck carcinoma patients who underwent definitive radio(chemo)therapy. Methods: Twenty four patients who were all treated with radio(chemo)terapy with curative intent for head and neck cancer (HNC) were included in the study. All patients were analyzed in terms of age at diagnosis, gender, body mass index, stage, radiotherapy dose/ fraction, chemotherapy (CT), pre-treatment complete blood count parameters, the pre-treatment systemic immune-inflammation index, local relapse, distant failure, overall survival (OS), and disease-free survival (DFS). Results: SII index was observed to be higher in locally advanced patients than in stage I/II patients (p=0.004). In addition, as a result of the evaluation made with ROC (receiver operating characteristic) analysis, it was observed that the SII index had a diagnostic value in predicting locally advanced disease (AUC:0.867, 95% CI :0.721-1.00, p=0.002). DFS and OS rates were 79% and 90% at a median follow-up of 9 months. Conclusions: The systemic immune-inflammation index predicts more advanced disease in non-surgically managed head and neck cancer patients. It can be considered as a biomarker that can contribute to the management of definitive radio(chemo)therapy.

Keywords:

Head and neck carcinoma, Radiotherapy, Systemic immune-inflammation index,

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