Correlation of Neck Nodule Size with Body Mass Index and Karnofsky Status Before and After Neoadjuvant Cisplatin and 5-Fluorouracil Chemotherapy in Nasopharyngeal Carcinoma Type 3 Patients

Abstract

Introduction: Nasopharyngeal carcinoma (NPC) is a malignancy arising from the nasopharyngeal epithelium, usually present in the Rosenmüller fossa. NPC is a cancer of the head and neck that is most common in East Asia and Southeast Asia, including in Indonesia. The main therapeutic for NPC is radiotherapy. Neoadjuvant chemotherapy reduces the local spread of advanced NPC, eradication of micrometastases, and improved local control. Neoadjuvant chemotherapy's effectiveness can be assessed by changes in the patient's neck nodule size (N), the patient's Body Mass Index (BMI), and Karnofsky's Status. Aim: To determine the correlation between N with BMI and Karnofsky status on neoadjuvant chemotherapy Cisplatin and 5-Fu in WHO type 3 of NPC patients. Methods: This study was an analytical observational study using medical record data. In this study, an assessment of N, BMI and Karnofsky status of NPC WHO type 3 patients who had undergone neoadjuvant chemotherapy using the Cisplatin and 5-Fu regimen for three cycles. Twenty-three study subjects were analyzed for N, BMI and Karnofksy status changes while undergoing neoadjuvant chemotherapy for up to 3 cycles. Result: The N value decreased, p = 0.001. BMI value decreased, p = 0.615. Karnofsky's status value experienced insignificant changes, p = 0.564. The correlation between N and BMI before a cycle I neoadjuvant chemotherapy and three cycles of neoadjuvant chemotherapy obtained r = -0.201 and p = 0.358, respectively; r = -0.070 and p = 0.751. Correlation of N with Karnofsky status was obtained r = 0.155 and p = 0.480, before cycle I neoadjuvant chemotherapy. The correlation between N and Karnofsky status was obtained r = 0.571 and p = 0.004 after cycle III neoadjuvant chemotherapy. Conclusion: Neoadjuvant chemotherapy Cisplatin and 5-Fu is effective against changes in N and correlation between N and BMI but less effective in assessing the correlation between N and Karnofsky status after three cycles of neoadjuvant chemotherapy. Correspondence should be addressed to Bagus Harning Efranto; bagushe16@gmail.com

The effect of neutrophil-lymphocyte ratio on neck nodule size in nasopharyngeal carcinoma chemotherapy

“…18,19 Administration of chemotherapy with an optimal dose and the right duration will be able to maintain a low NLR value, whereas a low NLR during neoadjuvant chemotherapy will provide a better response to therapy. 20 Research conducted by Efranto et al 21 , showed that there was a reduction or reduction in the size of the neck nodules in patients with Cisplatin and 5-FU neoadjuvan chemotherapy with significant results. This was corroborated by several researches reported that neoadjuvant chemotherapy had a higher potential for reducing distant metastatic failure, especially in patients with extensive nodules.…”

“…This was corroborated by several researches reported that neoadjuvant chemotherapy had a higher potential for reducing distant metastatic failure, especially in patients with extensive nodules. The research by Al-Amro et al, cited by Efranto et al 21 , assessed the effectiveness of neoadjuvant chemotherapy Cisplatin and Epirubicin followed by Cisplatin chemotherapy along with radiotherapy in 110 patients with advanced NPC showed complete remission and partial remission achieved in 87 subjects (79%) and 23 subjects (21%) respectively.…”