C-reactive protein level predicts prognosis in patients with locoregionally advanced laryngeal carcinoma treated with chemoradiotherapy.
The aim of this study was to investigate the effect of C-reactive protein (CRP) level on the prognosis of patients with locoregionally advanced laryngeal carcinoma treated with chemoradiotherapy. Fifty-seven patients with locoregionally advanced laryngeal carcinoma (cT3-4, N0-3, M0) treated with chemoradiotherapy were reviewed retrospectively. Chemoradiotherapy comprised external beam radiotherapy to the larynx (70 Gy) with three cycles of cisplatin at 3-week intervals. Elevated CRP was defined as >8 mg/L. The survival rate was calculated using the Kaplan-Meier method, and a multivariate analysis was used to identify significant factors associated with prognosis, using a Cox proportional hazards model. During the median (range) follow-up of 5 years (1.3-5), 29 patients died from laryngeal cancer; the 5-year cancer-specific survival (CSS) rate was 49.12%. Fifteen patients had a high CRP level before chemoradiotherapy (>8 mg/L), and their CSS rate was significantly worse than that in the remaining patients (P = 0.003). Multivariate analysis showed that CRP and tumor site were independent prognostic indicators for CSS, with a hazard ratio of 2.66 (95% confidence interval (CI), 1.22-5.82; P = 0.014) and a hazard ratio of 1.67 (95% CI, 1.01-2.77; P = 0.045), respectively. Of those with elevated CRP, the CRP levels of ten patients became normal after chemoradiotherapy, of whom four were alive with no evidence of recurrence or metastasis during the follow-up. By contrast, all six with no CRP normalization after chemoradiotherapy died within 3.8 years. The elevation of CRP before treatment predicts a poor prognosis in patients with locoregionally advanced laryngeal carcinoma treated with chemoradiotherapy.
Department of Medical Oncology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110022, China. wellyy2005@hotmail.com
Yue-Can
YC
Zeng
Ming
M
Xue
Feng
F
Chi
Zhao-Guo
ZG
Xu
Guo-Liang
GL
Fan
Rong
R
Wu
Yu-Chen
YC
Fan
Wen-Zhao
WZ
Zhong
Si-Liang
SL
Wang
Xiao-Ye
XY
Zhang
Li-Na
LN
Wu
Xiao-Dong
XD
Chen
Xue-Ying
XY
Jin
Qiong-Yu
QY
Duan
Ru
R
Xu
Wei
W
Chen
Hao-Chu
HC
Qian
Yu-Ping
YP
Xiao
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis
D002097:C-Reactive Protein