Effect of induction chemotherapy on immune function and inflammatory indicators in patients with nasopharyngeal carcinoma

doi:10.11958/20230792

Abstract

Abstract:

Objective To investigate the effect of induction chemotherapy (IC) on immune function and inflammatory markers in patients with stage Ⅲ-Ⅳ nasopharyngeal carcinoma (NPC). Methods A total of 102 patients with stage Ⅲ-Ⅳ NPC confirmed by pathology were selected to receive TPF regimen (docetaxel, cisplatin and 5-fluorouracil, 72 cases) or GP regimen (gemcitabine and cisplatin, 30 cases). The short-term clinical outcomes of patients were evaluated. The immune function of patients with different clinical characteristics was compared before and after IC treatment. T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), B lymphocyte subsets (CD19⁺) and NK cell percentage in peripheral blood before and after IC were compared. Inflammatory markers interleukin-6, tumor necrosis factor α (TNF-α), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and systemic immunoinflammatory index (SII), and changes of total protein (TP), albumin (ALB) and prealbumin (PA) were also compared. The immune function, inflammatory index and nutritional status of patients with different IC regimen and IC cycle number were compared. Results All 102 patients completed IC, of which 0 patient achieved complete response (CR), 87 patients (85.3%) achieved partial response (PR), 13 patients (12.7%) achieved stable response (SD), 2 patients (2.0%) developed PD. The objective response rate (ORR) was 85.3%, and the disease control rate (DCR) was 98.0%. The proportion of CD19⁺ lymphocytes and NK cells decreased after IC, while the proportion of CD3⁺, CD4⁺ and CD8⁺ lymphocytes increased after IC (P<0.05). Levels of NLR, SII, TP, ALB and PA were decreased in NPC patients after IC (P<0.05). After IC, the CD4⁺/CD8⁺ ratio was higher in the GP group than that in the TPF group, and LMR decreased (P<0.05). There were no significant differences in the immune function, inflammatory indexes and nutritional status before and after IC between the ≤3 cycle group and the > 3 cycle group. Conclusion IC is an effective therapy with high disease control rates for NPC patients, and can improve their cellular immune function, decrease humoral immune function, inflammatory indices and nutritional status.

Key words: nasopharyngeal carcinoma, induction chemotherapy, nutritional status, immune function, inflammatory indicators

CLC Number:

R739.63

Figures/Tables 8

References 27

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组别	n	PR	SD	PD	ORR	DCR
TPF组	72	60（83.3）	10（13.8）	2（2.8）	60（83.3）	70（97.2）
GP组	30	27（90.0）	3（1.0）	0	27（90.0）	30（100.0）
χ²					0.014	0.019

组别	n	PR	SD	PD	ORR	DCR
TPF组	72	60（83.3）	10（13.8）	2（2.8）	60（83.3）	70（97.2）
GP组	30	27（90.0）	3（1.0）	0	27（90.0）	30（100.0）
χ²					0.014	0.019

组别	n	PR	SD	PD	ORR	DCR
≤3周期组	70	62（88.6）	8（11.4）	0	62（88.6）	70（100.0）
>3周期组	32	25（78.1）	5（15.6）	2（6.3）	25（78.1）	30（93.8）
χ²					1.169	0.080

组别	n	PR	SD	PD	ORR	DCR
≤3周期组	70	62（88.6）	8（11.4）	0	62（88.6）	70（100.0）
>3周期组	32	25（78.1）	5（15.6）	2（6.3）	25（78.1）	30（93.8）
χ²					1.169	0.080

临床特征	n		CD3⁺/%	CD4⁺/%	CD8⁺/%	NK/%	CD4⁺/CD8⁺
性别男	76	11.71（7.60，14.45）	68.90（61.51，74.76）	37.26±8.98	27.99±9.31	18.10（12.31，26.80）	1.42（0.94，14.45）
女	26	9.59（8.26，13.22）	77.72（65.72，81.80）	39.17±9.36	30.82±9.66	12.21（8.55，21.42）	1.31（0.88，1.85）
Z或t		0.173	2.584^＊	0.929	1.327	2.277^＊	0.553
年龄 <52岁	51	10.96（8.50，15.81）	70.00（62.11，79.59）	38.34±9.96	28.48±9.84	15.52（8.40，24.44）	1.25（1.91，2.09）
≥52岁	51	9.52（5.90，13.24）	69.94（64.80，74.59）	37.12±8.18	28.95±9.09	18.00（12.25，24.58）	1.46（0.93，1.84）
Z或t		1.707	0.395	0.230	0.086	1.533	0.097
分期 Ⅲ期	39	11.32（9.05，16.24）	69.57（64.48，77.57）	37.59±8.82	27.72±8.47	17.00（9.40，23.78）	1.28（0.92，1.84）
Ⅳ期	63	9.00（7.02，13.02）	70.00（62.53，78.79）	7.84±9.29	28.58±10.05	17.93（11.60，24.73）	1.38（0.92，1.99）
Z或t		2.025	0.121	0.138	0.181	0.964	0.386
EBV DNA <500 copies/mL	76
EBV DNA <500 copies/mL	76	10.50（7.83，14.42）	69.97（62.97，78.08）	38.04±9.58	28.22±8.48	17.48（11.33，24.68）	1.35（0.92，1.87）
≥500 copies/mL	26	10.84（7.02，14.84）	68.37（62.02，78.08）	36.87±7.47	30.15±11.87	17.75（12.00，24.74）	1.28（0.09，1.87）
Z或t		0.151	0.872	1.129	0.078	0.530	0.228