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A nomogram with the peripheral blood neutrophil-to-lymphocyte ratio before treatment predicts the survival of patients with nasopharyngeal carcinoma

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机构: [1]Department of Radiation Oncology, Jiangxi Cancer Hospital & Institute, Jiangxi Clinical Research Center for Cancer, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China, [2]Department of Oncology, Huanggang Central Hospital, Huanggang, China, [3]Department of Oncology, The Affiliated Hospital of Southwest Medical University, Sichuan, China, [4]Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma, Medical College of Nanchang University, Nanchang, China
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关键词: nasopharyngeal carcinoma neutrophil-to-lymphocyte ratio overall survival prognostic factors nomograms

摘要:
This study was performed to investigate the relationship of the pretreatment neutrophil count and neutrophil-to-lymphocyte ratio (NLR) with the prognosis of nasopharyngeal carcinoma (NPC), as well as to establish an NLR-related nomogram to predict survival in patients with NPC.In total, 747 patients with NPC were enrolled between January 2005 and January 2015 at our hospital. Kaplan-Meier survival analysis was used to evaluate overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS), with comparisons made using the log-rank test. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors for OS, PFS, and DMFS. The optimal NLR cut-off value was determined using receiver operating characteristic curve analysis. A nomogram model was then constructed and validated using R software (Version 3.6.0).Among the 747 patients, N stage (P = 0.01, 0.042, 0.017) and NLR (P = 0.037) were identified as independent predictors of DMFS. Independent predictors of OS were sex (P = 0.024), age (P = 0.019), N stage (P = 0.006, 0.031, 0.002), American Joint Committee on Cancer (AJCC) stage (P = 0.003), adjuvant chemotherapy (P = 0.016), and NLR (P = 0.036). N stage (P = 0.001, 0.0221, 0.003), AJCC stage (P = 0.001), and NLR (P = 0.035) were also associated with PFS. The prognostic model showed good agreement with actual outcomes. Compared with the TNM staging system, the nomogram demonstrated superior accuracy and stability.In patients with NPC, an elevated pretreatment NLR was associated with poorer OS, PFS, and DMFS. The NLR-based nomogram provided more accurate survival prediction than clinical staging and may serve as a valuable tool in guiding prognosis and treatment planning.Copyright © 2025 Zhang, Feng, Pang, Yu, Lu, Li, Xu and Jiang.

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出版当年[2025]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
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第一作者机构: [1]Department of Radiation Oncology, Jiangxi Cancer Hospital & Institute, Jiangxi Clinical Research Center for Cancer, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China,
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通讯机构: [1]Department of Radiation Oncology, Jiangxi Cancer Hospital & Institute, Jiangxi Clinical Research Center for Cancer, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China, [4]Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma, Medical College of Nanchang University, Nanchang, China
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