Predictive Value of Prognostic Nutritional Index for Radiotherapy and Prognosis of Esophageal Squamous Cell Carcinoma in the Elderly Patients

Abstract

To evaluate the role of prognostic nutritional index (PNI) in elderly patients with esophageal squamous cell carcinoma. A retrospective analysis of 108 patients with esophageal squamous cell carcinoma who underwent radical radiotherapy or concurrent chemoradiotherapy in the elderly (over 65 years old). The PNI value of each patient was calculated, and the best cutoff value of PNI before treatment was determined by establishing the receiver operating characteristic curve (ROC curve). The values were divided into low PNI group and high PNI group, and efficacy of radiotherapy and overall survival time were analyzed between the two groups. The ROC curve showed that the PNI optimal cutoff value is 50.1. There were no significant differences in age, gender, and treatment between the two groups, and there was difference in TNM staging (p=0.022). There was a significant difference in radiotherapy efficacy between the two groups (p < 0.001). The 1-, 2-, and 3-year overall survival of high PNI were 94.2%, 69.2%, and 61.5%, respectively. The 1-, 2-, and 3-year overall survival of the low PNI group were 69.6%, 32.1%, and 26.8%, respectively. Learning differences (p < 0.001). Univariate analysis showed that PNI, T stage, N stage, and TNM stage were related to the overall survival time of patients (both P<0.01). Cox multivariate analysis showed that N stage (RR=1.944, 95% CI=1.285-2.940, p=0.002) and PNI (RR=0.832, 95% CI=0.770-0.899, p<0.001) were independent risk factors affecting overall survival. PNI has a good correlation with the prognosis and radiotherapy efficacy of patients, which can be used as an important index to predict the benefit of radiotherapy for esophageal squamous cell carcinoma in the elderly.