Analysis Of Efficacy And Prognostic Factors For Comprehensive Treatment Of 95 Patients With Locally Advanced Head And Neck Squamous Cell Carcinoma

Objective : Analyze the curative effect and survival analysis of locally advanced head and neck squamous cell carcinoma obtained by comprehensive treatment in our hospital,and find out the predictable indicators.Methods : A total of 95 patients with locally advanced head and neck squamous cell carcinoma who underwent comprehensive treatment in our department's radiotherapy department from July 2012 to December 2017 were collected.All patients had undergone surgery and postoperative adjuvant radiotherapy / radiotherapy.ROC was used to determine the optimal thresholds for NLR and PLR.Survival rates were calculated using Kaplan-Meier method,log-rank test was used for univariate analysis,and Cox risk regression model was used for multivariate analysis.Define p ? 0.05 as statistically significant.Results : The median follow-up time was 38 months(3-75 months),and the follow-up rate was 100%.he OS of the whole group of patients at 3 years and 5years were: 71.2% and 63.6%;PFS at 3 years and 5 years were: 64.2% and 56.9%;DMFS at 3 years and 5 years were: 88.7% and 86.0%.The 3-year OS,PFS,and DMFS of the pre-operative low NLR group and the high-NLR group were 73.1%?62.1%?86.0% and 31.2%?32.1%?49.6%;The 3-year OS,PFS,and DMFS of the pre-operative low PLR group and the high-PLR groupe were 75.1%?62.7%?86.5%and 44.0% ? 44.6% ? 65.5%.Two groups had significant difference(p?0.05).Univariate analysis showed that preoperative NLR,preoperative PLR,postoperative radiotherapy time,surgical margin,nerve invasion,vascular cancer thrombus,drinking history,clinical stage,degree of differentiation,and comorbidities are poor prognostic factors of OS(P?0.05);Preoperative NLR,preoperative PLR,surgical margin,nerve invasion,and concurrent chemotherapy are poor prognostic factors of PFS(P?0.05);Preoperative NLR and preoperative PLR are poor prognostic factors of DMFS(P?0.05).Multivariate analysis showed that preoperative NLR was an independent prognostic factor of OS and PFS(P?0.001).Conclusion: 1.For locally advanced head and neck squamous cell carcinoma,postoperative adjuvant radiotherapy/radiochemotherapy can benefit overall survival.2.Postoperative radiotherapy more than 6 weeks,positive surgical margin,nerve invasion,and vascular tumor thrombus are important factors to affect prognosis.3.High NLR in preoperative is an independent prognostic factor of OS and PFS.4.Preoperative NLR/PLR may predict advanced head and neck squamous cancinoma prognosis.