Pretreatment Geriatric Nutritional Risk Index in RADPLAT-treated Patients With Oral Squamous Cell Carcinoma: A Pilot Study

Background/Aim: Pretreatment nutritional and inflammatory indices have been associated with prognosis in patients with oral squamous cell carcinoma (OSCC) undergoing surgery or chemoradiotherapy; however, their prognostic significance in patients treated with superselective intra-arterial infusion of cisplatin and concomitant radiation therapy (RADPLAT) remains unknown. The present study aimed to clarify this point. Patients and Methods: This study analyzed 35 patients who underwent RADPLAT at our institution between March 2014 and June 2024. Pretreatment geriatric nutritional risk index (GNRI), body mass index (BMI), serum albumin, prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and absolute lymphocyte count (ALC) were evaluated as potential prognostic parameters for event-free survival (EFS), overall survival (OS), and local control (LC). Univariate Cox proportional hazards analysis was performed for all endpoints, and stepwise multivariate analysis was additionally performed for EFS and OS. Results: The 2-year EFS, OS, and LC rates were 63.1%, 86.2%, and 92.9%, respectively. On univariate analysis, lower GNRI and BMI were significantly associated with poorer EFS, OS, and LC. GNRI remained an independent prognostic factor for both EFS and OS on multivariate analysis. Kaplan-Meier analysis demonstrated significantly worse EFS and OS in the low-GNRI group (GNRI <92) compared with the high-GNRI group (GNRI ≥92) (log-rank p=0.011 and p=0.027, respectively). In contrast, PNI, NLR, and ALC were not significantly associated with any endpoint. Conclusion: Pretreatment GNRI was associated with clinical outcomes in patients with OSCC undergoing RADPLAT, suggesting that nutritional status might be a useful prognostic parameter. These findings require validation in larger prospective studies.