2781 - Association of Systemic Inflammation Response Index with Outcomes for Head and Neck Cancer
Presenter(s)
A. Koempel1, S. J. Ma2, S. Zhu3, P. Bhateja4, E. Gogineni5, S. Baliga5, D. J. Konieczkowski5, D. L. Mitchell5, S. R. Jhawar6, J. C. Grecula5, M. Old7, J. W. Rocco7, M. Bonomi4, and D. M. Blakaj8; 1Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, 2Ohio State University, Columbus, OH, 3University of Florida, Gainesville, FL, 4Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, 5Department of Radiation Oncology, James Cancer Hospital/Wexner Medical Center, The Ohio State University, Columbus, OH, 6Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, 7The Ohio State University Department of Otolaryngology - Head & Neck Surgery, Columbus, OH, 8Department of Radiation Oncology, James Cancer Hospital, The Ohio State University, Columbus, OH
Purpose/Objective(s): Systemic inflammation is an important factor for carcinogenesis and tumor progression. Systemic Inflammation Response Index (SIRI) was suggested as one of peripheral blood biomarkers to assess the extent of inflammation. Herein, we aimed to evaluate the prognostic value of SIRI in patients who received definitive radiation or chemoradiation.
Materials/Methods: A single-institution database at a comprehensive cancer center was queried for patients with non-metastatic head and neck cancer diagnosed between December 2011 and March 2020 who underwent definitive radiation or chemoradiation with SIRI available for analysis. With the top quartile as a reference to evaluate high versus low SIRI, logistic MVA was performed to identify variables associated with high SIRI. Cox multivariable analysis (MVA) and Fine-Gray MVA were performed to evaluate survival and cancer control outcomes using SIRI as a continuous variable. Cox and Fine-Gray MVA were repeated among the subgroup of patients based on p16 status.
Results: A total of 376 patients met our criteria (308 men [81.9%]; median age 61 years [interquartile range 55-68 years]. Median follow up of 50.1 months (interquartile range 41.4-64.7). Using the top quartile cutoff of 3.16 for SIRI, those with underweight body mass index (vs normal body mass index; adjusted odds ratio [aOR] 5.24, 95% CI 1.41-21.58, p=0.02) and Eastern Cooperative Oncology Group performance status (ECOG PS) of 1 or higher (vs ECOG PS 0; aOR 1.85, 95% CI 1.10-3.13, p=0.02) were more likely to have high SIRI, while others with non-Caucasian race were less likely to have high SIRI (aOR 0.30, 95% CI 0.09-0.80, p=0.03). In the entire cohort, higher SIRI as a continuous variable was not associated with overall survival (OS; adjust hazards ratio [aHR] 1.05, 95% confidence interval [CI] 1.00-1.10, p=0.07), progression-free survival (PFS; aHR 1.03, 95% CI 0.98-1.08, p=0.28), locoregional failure (LRF; aHR 1.02, 95% CI 0.88-1.19, p=0.77), or distant failure (DF; aHR 1.07, 95% CI 0.97-1.17, p=0.19). Similar findings were observed among 220 patients with p16-positive tumors (OS: aHR 1.02, 95% CI 0.94-1.10, p=0.72; PFS: aHR 1.01, 95% CI 0.93-1.10, p=0.86; LRF: aHR 1.10, 95% CI 0.92-1.31, p=0.30; DF: aHR 0.98, 95% CI 0.84-1.14, p=0.75). However, among 156 patients with p16-negative tumors, those with high SIRI had worse OS (aHR 1.11, 95% CI 1.03-1.18, p=0.004), PFS (aHR 1.11, 95% CI 1.03-1.20, p=0.005), and DF (aHR 1.12, 95% CI 1.04-1.21, p=0.005), but not LRF (aHR 1.04, 95% CI 0.80-1.34, p=0.78).
Conclusion: Elevated SIRI was an independent, adverse prognostic factor for survival and distant metastasis outcomes among patients with p16-negative tumors, but not p16-positive tumors. Being underweight, reduced performance status, and Caucasian race were associated with high SIRI. Further validation of SIRI would be warranted in a prospective setting.