Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective study

Abstract Background Despite concurrent chemoradiotherapy (CCRT) being the standard treatment for locally advanced nasopharyngeal carcinoma (NPC), there remains considerable variability in survival outcomes among patients with the same tumor-node-metastasis (TNM) staging. This study aims to evaluate...

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Main Authors: Wen-Chao Li, Wei-Qiong Ni, Yu-Ling Zhang, Yong-Miao Lin, Ao-Qiang Chen, Zhi-Qing Long, Si-Fen Wang, Fang-Fang Duan, Chao Zhang, Xin Huang, De-Huan Xie, Wen Xia, Sha-Sha Du, Xin Hua
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Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14413-4
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author Wen-Chao Li
Wei-Qiong Ni
Yu-Ling Zhang
Yong-Miao Lin
Ao-Qiang Chen
Zhi-Qing Long
Si-Fen Wang
Fang-Fang Duan
Chao Zhang
Xin Huang
De-Huan Xie
Wen Xia
Sha-Sha Du
Xin Hua
author_facet Wen-Chao Li
Wei-Qiong Ni
Yu-Ling Zhang
Yong-Miao Lin
Ao-Qiang Chen
Zhi-Qing Long
Si-Fen Wang
Fang-Fang Duan
Chao Zhang
Xin Huang
De-Huan Xie
Wen Xia
Sha-Sha Du
Xin Hua
author_sort Wen-Chao Li
collection DOAJ
description Abstract Background Despite concurrent chemoradiotherapy (CCRT) being the standard treatment for locally advanced nasopharyngeal carcinoma (NPC), there remains considerable variability in survival outcomes among patients with the same tumor-node-metastasis (TNM) staging. This study aims to evaluate the prognostic significance of the pretreatment Pan-Immune-Inflammation Value (PIV), an integrative marker of immune-inflammatory status, in NPC patients undergoing CCRT. Methods A total of 860 NPC patients treated with platinum-based CCRT were included in this retrospective study. PIV was derived from pretreatment peripheral blood counts, categorizing patients into high-PIV (> 244.4) and low-PIV (≤ 244.4) cohorts. Overall survival (OS) rates were estimated using Kaplan-Meier methods and analyzed through Cox proportional hazards models. A PIV-based prognostic nomogram was developed and subsequently validated. Results Patients classified with low PIV exhibited markedly improved OS compared to those with high PIV (HR = 0.559, 95% CI: 0.415–0.753, P < 0.001). In the multivariate analysis, PIV emerged as an independent prognostic indicator, alongside age, T stage, N stage, and body mass index (BMI). Furthermore, the PIV-based nomogram demonstrated enhanced prognostic accuracy (C-index: 0.680, 95% CI: 0.641–0.719) when contrasted with the traditional TNM staging system (C-index: 0.638, 95% CI: 0.573–0.703). Conclusions The pretreatment PIV serves as an independent prognostic factor in NPC patients receiving CCRT. The nomogram founded on PIV offers improved prognostic capacity over conventional TNM staging, thereby holding potential in guiding personalized treatment strategies for this patient demographic.
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spelling doaj-art-337c0352f3da466bb61cdc9d73d7d5e92025-08-20T03:43:11ZengBMCBMC Cancer1471-24072025-07-0125111110.1186/s12885-025-14413-4Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective studyWen-Chao Li0Wei-Qiong Ni1Yu-Ling Zhang2Yong-Miao Lin3Ao-Qiang Chen4Zhi-Qing Long5Si-Fen Wang6Fang-Fang Duan7Chao Zhang8Xin Huang9De-Huan Xie10Wen Xia11Sha-Sha Du12Xin Hua13Department of oncology, The Sixth Affiliated Hospital, School of Medicine, South China University of TechnologyDepartment of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin HospitalDepartment of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical CollegeState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterDepartment of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical UniversityState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer CenterDepartment of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical UniversityDepartment of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical UniversityAbstract Background Despite concurrent chemoradiotherapy (CCRT) being the standard treatment for locally advanced nasopharyngeal carcinoma (NPC), there remains considerable variability in survival outcomes among patients with the same tumor-node-metastasis (TNM) staging. This study aims to evaluate the prognostic significance of the pretreatment Pan-Immune-Inflammation Value (PIV), an integrative marker of immune-inflammatory status, in NPC patients undergoing CCRT. Methods A total of 860 NPC patients treated with platinum-based CCRT were included in this retrospective study. PIV was derived from pretreatment peripheral blood counts, categorizing patients into high-PIV (> 244.4) and low-PIV (≤ 244.4) cohorts. Overall survival (OS) rates were estimated using Kaplan-Meier methods and analyzed through Cox proportional hazards models. A PIV-based prognostic nomogram was developed and subsequently validated. Results Patients classified with low PIV exhibited markedly improved OS compared to those with high PIV (HR = 0.559, 95% CI: 0.415–0.753, P < 0.001). In the multivariate analysis, PIV emerged as an independent prognostic indicator, alongside age, T stage, N stage, and body mass index (BMI). Furthermore, the PIV-based nomogram demonstrated enhanced prognostic accuracy (C-index: 0.680, 95% CI: 0.641–0.719) when contrasted with the traditional TNM staging system (C-index: 0.638, 95% CI: 0.573–0.703). Conclusions The pretreatment PIV serves as an independent prognostic factor in NPC patients receiving CCRT. The nomogram founded on PIV offers improved prognostic capacity over conventional TNM staging, thereby holding potential in guiding personalized treatment strategies for this patient demographic.https://doi.org/10.1186/s12885-025-14413-4Nasopharyngeal carcinomaPan-immune-inflammation valueConcurrent chemoradiotherapyPrognosisNomogram
spellingShingle Wen-Chao Li
Wei-Qiong Ni
Yu-Ling Zhang
Yong-Miao Lin
Ao-Qiang Chen
Zhi-Qing Long
Si-Fen Wang
Fang-Fang Duan
Chao Zhang
Xin Huang
De-Huan Xie
Wen Xia
Sha-Sha Du
Xin Hua
Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective study
BMC Cancer
Nasopharyngeal carcinoma
Pan-immune-inflammation value
Concurrent chemoradiotherapy
Prognosis
Nomogram
title Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective study
title_full Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective study
title_fullStr Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective study
title_full_unstemmed Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective study
title_short Integrating pan-immune-inflammation value into personalized survival prediction of nasopharyngeal carcinoma: a large-scale long-term retrospective study
title_sort integrating pan immune inflammation value into personalized survival prediction of nasopharyngeal carcinoma a large scale long term retrospective study
topic Nasopharyngeal carcinoma
Pan-immune-inflammation value
Concurrent chemoradiotherapy
Prognosis
Nomogram
url https://doi.org/10.1186/s12885-025-14413-4
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