Prognostic Role of Systemic Inflammation Response Index for Cervical Cancer Patients Treated with Definitive Radiotherapy

Abstract

<h3>Purpose/Objective(s)</h3> It has been reported that blood inflammatory biomarkers were associated with survival of several cancers in previous studies. In this study, we retrospectively evaluated that systemic inflammation response index (SIRI) , one of blood inflammatory biomarkers, could be a prognostic factor in patients with cervical cancer who received definitive radiotherapy. <h3>Materials/Methods</h3> We assessed 101 patients with cervical cancer who received definitive radiotherapy combined external beam radiation therapy (EBRT) and brachytherapy between January 2009 and December 2020 in this study. The median follow-up time was 31(range, 3-126) months. We used peripheral blood results within 2 months before radiotherapy to calculated SIRI. The cutoff value of SIRI was decided by receiver operating characteristic (ROC) analysis. Survival was analyzed by Kaplan-Meier method and log-rank test was used for comparison of two groups. Cox proportional hazards model was performed for Univariate and multivariate analyses. <h3>Results</h3> The univariate analysis showed that SIRI and N-stage were significant prognostic factors for overall survival (OS). In the multivariate analysis, neither SIRI (HR=1.858, 95% CI: 0.581-5.94, p=0.296) nor N-stage (HR=2.804, 95% CI: 0.877-8.97, p=0.082) were related to OS. For progression-free survival (PFS), SIRI, N-stage and Performance status (PS) were significant prognosis factors by the univariate analysis. The multivariate analysis showed that SIRI (HR=2.204, 95% CI: 1.058-4.591, p=0.035) and N-stage (HR=2.804, 95% CI: 1.341-5.863, p=0.006) were independent prognostic factors of PFS. The Kaplan-Meier curve showed that the 3-years PFS rates of high SIRI (2.147≦) and Low SIRI (<2.147) were 35.3% and 70.2%, respectively (p=0.004). <h3>Conclusion</h3> In conclusion, this result suggested that pre-treatment SIRI is useful as a prognostic factor of survival for cervical cancer patients who received with definitive radiotherapy.