Clinical significance of inflammatory prognosis score in predicting the efficacy of neoadjuvant chemoradiotherapy for locally advanced rectal cancer
Objective To investigate the significance of pre-treatment inflammatory prognosis score in predicting tumor regression(TRG)and prognosis after neoadjuvant concurrent chemoradiotherapy(nCRT)in patients with locally advanced rectal cancer.Methods Clinical data of 90 patients with locally advanced rectal cancer were collected retrospectively.All patients received nCRT and total mesorectal resection.Multiple linear regression was used to analyze the relationship between inflammatory prognosis score and TRG grade,univariate Cox proportional regression analysis was used to evaluate the factors affecting patients'DFS,and Lasso-Cox model was used to further screen clinical factors related to DFS,and a column graph was constructed.The predictive efficiency of the prediction model was evaluated by using calibration graph and receiver operating characteristic curve.Results There were 53 patients with TRG1 to grade 2 and 37 patients with TRG3 to grade 4.TRG grade was related to differentiation degree,chemotherapy regimen,whether adjuvant radiotherapy,LMR,PNI,CII,NLR,PLR,MLR,CAR(P<0.05).Multiple linear regression analysis showed that neoadjuvant chemotherapy,CII and PNI were the factors of TRG grade(P<0.05).The results of univariate Cox proportional regression showed that mGPS≥1,NLR>1.90,PLR>0.13,PNI>47.58 and TRG1-2 were the risk factors affecting DFS.Adjuvant radiotherapy is a protective factor affecting DFS.The formula of Lasso-Cox regression to construct the nomogram model is:RiskScore=0.337×mGPS+0.191×NLR+0.332×PLR-0.276×PNI+0.466×TRG grade-0.208×adjuvant radiotherapy.The overall C-index of the model was 0.706,95%CI(0.642-0.769,P<0.05).The ROC curve showed that the area under the curve of DFS predicted by the model was 0.776(95%CI:0.676-0.876,P<0.05).Conclusion The inflammatory prognosis score can be used as a predictive marker for treatment response and prognosis of local advanced rectal cancer receiving nCRT+TME,and can help guide the subsequent treatment strategy.
Locally advanced rectal cancerDegree of tumor regressionPrognosisNeoadjuvant chemoradiotherapy
NETL
NSTL
万方数据
