Table 4.
Univariate and multivariate Cox regression analyses of factors associated with 2-year mortality rates of 69 OCC patients treated with postoperative adjuvant CCRT and 54 NOCC patients treated with primary CCRT.
| OCC with Postoperative Adjuvant CCRT | NOCC with Primary CCRT | |||||
|---|---|---|---|---|---|---|
| Variables | Univariate | Multivariate | Univariate | Multivariate | ||
| p-Value | HR (95% CI) | p-Value | p-Value | HR (95% CI) | p-Value | |
| Clinicopathologic | ||||||
| Sex (ref: female) | 0.979 | 0.860 | ||||
| Age | 0.949 | 0.014 * | 1.088 (1.019~1.093) | 0.012 * | ||
| TNM stage (ref: IV) | 0.982 | 0.211 | ||||
| T status (ref: T3-4) | 0.347 | 0.166 | ||||
| N status (ref: N2-3) | 0.161 | 0.156 | ||||
| Histologic grade (ref: poorly differentiated) | 0.019 * | 0.810 | ||||
| ECOG performance status (ref: 2) | 0.012 * | 0.180 (0.038~0.842) | 0.006 * | 0.333 | ||
| Smoking (ref: yes) | 0.645 | 0.487 | ||||
| Alcohol (ref: yes) | 0.053 | 0.440 | ||||
| Betel nut (ref: yes) | 0.264 | 0.996 | ||||
| HN-CCI (ref: no) | 0.047 * | 0.255 | ||||
| Tracheostomy (ref: yes) | 0.732 | 0.055 | ||||
| CCRT | ||||||
| RT dose (Gy) | 0.446 | 0.222 | ||||
| RT fractions | 0.255 | 0.411 | ||||
| RT duration (days) | 0.140 | 0.101 | ||||
| Cisplatin dose | 0.774 | 0.458 | ||||
| CCRT-induced grade 3/4 toxicity | ||||||
| Dermatitis (ref: yes) | 0.037 * | 0.746 | ||||
| Pharyngitis (ref: yes) | 0.012 * | 0.237 | ||||
| Mucositis (ref: yes) | 0.958 | 0.885 | ||||
| Infection (ref: yes) | 0.394 | 0.027 * | ||||
| Emesis (ref: yes) | 0.218 | 0.469 | ||||
| Anemia (ref: yes) | 0.970 | 0.211 | ||||
| Neutropenia (ref: yes) | 0.855 | 0.969 | ||||
| Thrombocytopenia (ref: yes) | 0.306 | 0.555 | ||||
| Mean daily calorie intake during CCRT (ref: ≥30) | 0.045 * | 0.039 * | ||||
| Mean protein intake during CCRT | 0.269 | 0.478 | ||||
| Feeding tube placement (ref: yes) | 0.039 * | 0.052 | ||||
| Mean days of feeding tube placement during CCRT | 0.001 * | 0.022 * | ||||
| Nutritional and inflammatory markers | ||||||
| Before CCRT | ||||||
| BMI (kg/m2) | 0.005 * | 0.011 * | ||||
| BW (kg) | 0.004 * | 0.008 * | ||||
| Hb (g/dL) | 0.128 | 0.098 | ||||
| WBC (×103 cells/mm3) | 0.061 | 0.621 | ||||
| Platelet count (×103/mm3) | 0.024 * | 0.564 | ||||
| TLC (×103 cells/mm3) | 0.133 | 0.101 | ||||
| Albumin (g/dL) | 0.191 | 0.056 | ||||
| CRP (mg/dL) | 0.038 * | 0.541 | ||||
| NLR | 0.179 | 0.023 * | 1.250 (1.014~1.311) | 0.027 * | ||
| PLR | <0.001 * | 1.004 (1.002~1.005) | <0.001 * | 0.111 | ||
| PNI | 0.022 * | 0.009 * | ||||
| Treatment interval changes (%) | ||||||
| ΔBW% ** | 0.035 * | 0.502 | ||||
| ΔBMI% ** | 0.121 | 0.440 | ||||
| ΔHb% ** | 0.544 | 0.052 | ||||
| ΔWBC% ** | 0.818 | 0.008 * | ||||
| ΔPlatelet% ** | 0.041 * | 0.543 | ||||
| ΔTLC% ** | 0.481 | 0.798 | ||||
| ΔAlbumin% ** | 0.346 | 0.410 | ||||
| ΔCRP% ** | 0.046 * | 0.055 | ||||
| ΔNLR% ** | 0.009 * | 0.048 * | ||||
| ΔPLR% ** | 0.733 | 0.122 | ||||
| ΔPNI% ** | 0.419 | 0.869 | ||||
| PG-SGA before CCRT (ref: stage C) | 0.007 * | 0.098 | ||||
| Body composition parameters | ||||||
| Factor 1 | 0.023 * | 0.430 | ||||
| Factor 2 | 0.871 | 0.008 * | 0.477 (0.020~0.777) | 0.008 * | ||
| Factor 3 | 0.003 * | 1.562 (1.094~2.229) | 0.014 * | 0.054 | ||
| Factor 4 | 0.098 | 0.358 | ||||
* indicates a significant p-value < 0.05 Abbreviations: CCRT, concurrent chemoradiotherapy; HR, hazard ratio; CI, confidence interval; TNM, tumor node metastasis; ECOG, Eastern Collaboration Oncology Group; HN-CCI, head and neck Charlson Comorbidity Index; RT, radiotherapy; PG-SGA, Patient-Generated Subjective Global Assessment; BMI, body mass index; BWL, body weight loss; Hb, hemoglobin; WBC, white cell count; TLC, total lymphocyte count; CRP, C-reactive protein; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to lymphocyte ratio; PNI, prognostic nutritional index. ** Δ indicates a value obtained by subtracting the pretreatment value from the post-treatment value. % indicates (Δ value/the pretreatment value) × 100%.