2704 - Association of Systemic Inflammation Response Index with Outcomes among Patients with Head and Neck Cancer Receiving Definitive Chemoradiation
Presenter(s)
N. Almeida1, S. J. Ma2, V. Gupta1, K. E. Wooten1, M. Markiewicz1, R. Mcspadden1, W. L. Hicks1, M. K. Farrugia1, and A. K. Singh3; 1Roswell Park Comprehensive Cancer Center, Buffalo, NY, 2Department of Radiation Oncology, James Cancer Hospital/Wexner Medical Center, The Ohio State University, Columbus, OH, 3Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY
Purpose/Objective(s): Inflammation is integral to immune evasion and carcinogenesis. In recent years, Systemic Inflammation Response Index (SIRI) has been proposed as a pretreatment peripheral blood biomarker. However, there is a paucity of literature evaluating association between SIRI and outcomes in the US patient population. The aim of this study is to evaluate the prognostic role of SIRI in patients with head and neck cancer.
Materials/Methods: Institutional database at a comprehensive cancer center was queried for patients with non-metastatic head and neck cancer who received definitive chemoradiation between June 2007 and April 2023 with SIRI available. Cox and Fine-Gray MVA were performed to evaluate survival and cancer control outcomes using SIRI as a continuous variable. Propensity score matching was performed based on the median value as a cutoff for SIRI. Subgroup analyses were performed based on p16 status.
Results: A total of 656 patients met our criteria (535 men [81.6%]; median age 61 years [interquartile range 54.9-67.0]). Median follow up was 30.3 months (interquartile range 10.0-60.8). Those with higher SIRI as a continuous variable had worse overall survival (OS; adjusted hazards ratio [aHR] 1.10, 95% confidence interval [CI] 1.05-1.15, p<0.001), progression-free survival (PFS; aHR 1.09, 95% CI 1.04-1.14, p<0.001), and locoregional failure (LRF; aHR 1.09, 95% CI 1.01-1.17, p=0.03), but not distant failure (DF; aHR 1.07, 95% CI 0.96-1.19, p=0.24). Similar findings were observed in 253 matched pairs with 1.30 as a median value of SIRI (OS: aHR 1.60, 95% CI 1.16-2.19, p=0.004; PFS: aHR 1.49, 95% CI 1.12-1.98, p=0.006; LRF: aHR 1.74, 95% CI 1.03-2.93, p=0.04; DF: aHR 1.16, 95% CI 0.72-1.89, p=0.54). Among 263 patients with p16-negative tumors, higher SIRI was associated with worse OS (aHR 1.08, 95% CI 1.03-1.14, p=0.003) and PFS (aHR 1.06, 95% CI 1.01-1.12, p=0.03), but not LRF (aHR 1.04, 95% CI 0.96-1.13, p=0.36) and DF (aHR 1.04, 95% CI 0.86-1.25, p=0.71). For 339 patients with p16-positive tumors, higher SIRI was associated with worse PFS (aHR 1.14, 95% CI 1.02-1.28, p=0.03) and LRF (aHR 1.48, 95% CI 1.15-1.89, p=0.002), but not OS (aHR 1.06, 95% CI 0.92-1.22, p=0.42) and DF (aHR 1.12, 95% CI 0.92-1.37, p=0.25).
Conclusion: Elevated SIRI was an independent adverse prognostic factor for survival outcomes. When stratified by p16 status, high SIRI was associated with poor locoregional control for p16-positive tumors and poor survival outcomes without detriment cancer control for p16-negative tumors.