Jian-Xu Li, Mei-Ling He, Mo-Qin Qiu, Liu-Ying Yan, Mei-Ying Long, Jian-Hong Zhong, Rui-Jun Zhang, Chun-Feng Liang, Ya-Dan Pang, Jun-Kun He, Qian-Qian Chen, Jin-Xia Weng, Shi-Xiong Liang, and Bang-De Xiang
Abstract Background For patients with unresectable hepatocellular carcinoma (uHCC), intensity-modulated radiotherapy (IMRT) has become one of the options for clinical local treatment. Immune parameters, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and systemic immune inflammatory (SII), predict survival in various cancers. This study aimed to determine whether peripheral immune parameters can predict survival in patients with uHCC undergoing IMRT and establish a clinically useful prognostic nomogram for survival prediction. Methods The clinical data of 309 HCC patients were retrospectively analyzed and randomly divided into training (n = 216) and validation (n = 93) cohorts. PLR, NLR and SII were collected before and after IMRT. Univariate and multivariate Cox analyses were performed to identify independent prognostic factors affecting survival, which were used to generate a nomogram. Results The median survival was 16.3 months, and significant increases in PLR, NLR, and SII were observed after IMRT (P