Outcomes and prognostic markers in locally advanced head and neck squamous cell carcinoma underwent chemoradiotherapy

Head and neck squamous cell carcinoma (HNSCC) has poor survival outcomes, particularly in locally advanced stages. Identifying prognostic factors can help personalize treatment and improve outcomes.

We retrospectively analyzed stage III-IVA/B HNSCC patients who received definitive or adjuvant CRT from January 2015 to January 2024. Demographic, clinical, and laboratory data were collected.

The study included 138 patients. A total of 84 patients received CRT for the definitive aim, while 55 patients received it for the adjuvant aim. The median event free survival (EFS) was 7.65 years (95%CI 6.14-9.15). Factors associated with poor EFS in multivariate analysis were stage IVA/B disease (HR 2.58, 95%CI 1.21-5.49), being underweight (HR 3.54, 95%CI 1.57-7.96), and higher NLR (HR 2.51, 95%CI 1.30-4.85). Stage IVA/B disease were associated with poorer OS in multivariate analysis (HR 3.07, 95%CI 1.22-7.69). Male gender was associated with prolonged EFS and overall survival (HR 0.51, 95%CI 0.27-0.96 and HR 0.33, 95%CI 0.15-0.74, respectively).

In conclusion, female gender, stage IVA/B disease, being underweight, and having a high NLR were independent predictors of EFS while female gender and stage IVA/B disease were independent predictors for OS in patients with HNSCC who were treated with CRT.