(0603) A Predictive Survival Model for Stage IV Nasopharyngeal Squamous Cell Carcinoma Patients Treated With Chemoradiation

Introduction: To evaluate the pretreatment and posttreatment clinical factors associated with rate of survival at 1, 3, and 5 years in stage IV nasopharyngeal cancer patients treated with concurrent chemoradiation with/without neoadjuvant chemotherapy.

Methods: This retrospective cohort study involved 61 Stage IV nasopharyngeal cancer patients that were treated at our tertiary referral center between 2008 and 2020. The pretreatment and posttreatment clinical parameters including nutritional status and inflammatory markers were retrospectively reviewed.

Results: The 5-year overall survival rate for all patients was 54.1%. In multivariate analyses, posttreatment body mass index (BMI) < 21.6 kg/m2 (hazard ratio [HR] 3.003, 95% confidence interval [CI] 1.34–6.757, p = 0.008) and pretreatment systemic inflammation response index (SIRI) ≥ 125 (HR 2.841, 95% CI 1.256–6.429, p = 0.012) were independent indicators for worsened DSS. Posttreatment BMI < 21.6 kg/m2 (HR 2.681, 95% CI 1.048–5.376, p = 0.005), change in BMI < -1.93 kg/m2 (HR 2.222, 95% CI 1.048–4.717, p = 0.037), and pretreatment SIRI ≥ 125 (HR 3.074, 95% CI 1.518–6.225, p = 0.002) were independent indicators for worsened DFS. A nomogram was developed using posttreatment BMI and pretreatment SIRI to forecast DSS.

Conclusions: The posttreatment BMI, change in BMI, and pretreatment SIRI are associated with survival in patients with stage IV nasopharyngeal cancers. The developed nomogram aids in survival prediction and treatment adjustment.