ArticleFrontiers in immunology2026
Prognostic significance of immune-inflammatory and nutritional indicators in locoregionally advanced nasopharyngeal carcinoma.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This investigation was conducted to evaluate the prognostic relevance of immune-inflammatory and nutritional biomarkers in patients diagnosed with locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Methods: This retrospective analysis included 267 patients. We utilized principal component analysis (PCA) for dimensionality reduction. The estimation of survival outcomes relied on Kaplan-Meier curve analysis. Multivariate Cox regression was performed to pinpoint independent prognostic factors, which facilitated the subsequent development of a nomogram. The predictive accuracy of the nomogram was evaluated using calibration curves alongside decision curve analysis (DCA). Internal validation was performed using the bootstrap resampling method with 1,000 iterations. Results: PCA yielded two major components, including C1 (immune-inflammatory index) and C2 (nutritional index). The cut-off value of C2 was -0.242. Patients with high C2 (≥ -0.242) exhibited significantly better survival than those with a low C2 (< -0.242). Multivariate analysis confirmed age, T stage, lactate dehydrogenase level, and C2 as independent predictors. The resulting nomogram demonstrated strong predictive accuracy, with a concordance index (C-index) of 0.738, and was well-calibrated. DCA indicated a greater net clinical benefit compared to conventional treatment strategies. The bias-corrected C-index was 0.7177 using the bootstrap resampling method. Using the nomogram's risk score, patients were divided into low- and high-risk groups, with the low-risk group showing significantly superior survival. High-risk patients receiving induction chemotherapy before radiotherapy or concurrent chemoradiotherapy (RT/CCRT) experienced significantly greater gains in overall survival and locoregional relapse-free survival than RT/CCRT alone. By contrast, for low-risk individuals, equivalent efficacy was observed following either treatment approach. Conclusion: The C2 represents a reliable prognostic marker in LA-NPC. The developed nomogram enables personalized risk evaluation and aids in clinical decisions regarding tailored therapeutic approaches.
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