Pan-immune-inflammation value predicts 2-year recurrence after chemoradiotherapy in nasopharyngeal carcinoma
Ke Du1, Zhaoyuan Li1, Qi Zhang1
1Department of oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangcheng District, Xiangyang City, Hubei Province, China.
Background:
Nasopharyngeal carcinoma (NPC) remains a clinically challenging head and neck malignancy with a substantial risk of post-treatment recurrence, underscoring the need for accessible biomarkers that complement established staging and Epstein-Barr virus (EBV)-DNA assessment. This retrospective cohort study evaluated the prognostic utility of the pan-immune-inflammation value (PIV), a composite biomarker integrating neutrophil, platelet, monocyte, and lymphocyte counts, for predicting 2-year recurrence in patients with NPC treated with chemoradiotherapy.
Methods:
We retrospectively analyzed 306 patients with NPC treated at a tertiary center between February 2017 and April 2023, with follow-up until recurrence or April 2025. Baseline clinical, laboratory, imaging, and pretreatment EBV-DNA data were evaluated, and patients were stratified into recurrence and recurrence-free groups according to 2-year follow-up. Predictive performance and survival associations were assessed using receiver operating characteristic (ROC) analysis, Kaplan-Meier analysis with the log-rank test, and univariate and multivariate Cox regression models.
Results:
PIV was significantly elevated in the recurrence group (380.88 ± 204.99 vs. 329.76 ± 193.92, P = 0.037), indicating its association with immune-inflammatory activation. Receiver operating characteristic (ROC) analysis demonstrated moderate predictive accuracy (AUC = 0.582, 95% CI: 0.512-0.651, P = 0.023), with an optimal cutoff of 381.55 yielding 44.7% sensitivity and 73.1% specificity. Kaplan-Meier survival analysis revealed shorter recurrence-free survival (RFS) in high-PIV patients (mean RFS: 18.69 ± 0.75 vs. 20.41 ± 0.48 months, log-rank P = 0.004). Univariate and multivariate Cox regression confirmed advanced T stage (HR = 2.354, 95% CI: 1.421-3.900, P = 0.001) and elevated PIV (HR = 1.698, 95% CI: 1.130-2.553, P = 0.011) as independent predictors of recurrence.
Conclusions:
These findings suggest that PIV may serve as a cost-effective adjunctive tool for recurrence risk stratification, although the retrospective design and moderate sensitivity indicate that prospective multicenter validation is required before routine clinical application.
