{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:19:01Z","timestamp":1788153541657,"version":"build-2803163510"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This investigation was conducted to evaluate the prognostic relevance of immune-inflammatory and nutritional biomarkers in patients diagnosed with locoregionally advanced nasopharyngeal carcinoma (LA-NPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis included 267 patients. We utilized principal component analysis (PCA) for dimensionality reduction. The estimation of survival outcomes relied on Kaplan-Meier curve analysis. Multivariate Cox regression was performed to pinpoint independent prognostic factors, which facilitated the subsequent development of a nomogram. The predictive accuracy of the nomogram was evaluated using calibration curves alongside decision curve analysis (DCA). Internal validation was performed using the bootstrap resampling method with 1,000 iterations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PCA yielded two major components, including C1 (immune-inflammatory index) and C2 (nutritional index). The cut-off value of C2 was -0.242. Patients with high C2 (\u2265 -0.242) exhibited significantly better survival than those with a low C2 (&amp;lt; -0.242). Multivariate analysis confirmed age, T stage, lactate dehydrogenase level, and C2 as independent predictors. The resulting nomogram demonstrated strong predictive accuracy, with a concordance index (C-index) of 0.738, and was well-calibrated. DCA indicated a greater net clinical benefit compared to conventional treatment strategies. The bias-corrected C-index was 0.7177 using the bootstrap resampling method. Using the nomogram\u2019s risk score, patients were divided into low- and high-risk groups, with the low-risk group showing significantly superior survival. High-risk patients receiving induction chemotherapy before radiotherapy or concurrent chemoradiotherapy (RT\/CCRT) experienced significantly greater gains in overall survival and locoregional relapse-free survival than RT\/CCRT alone. By contrast, for low-risk individuals, equivalent efficacy was observed following either treatment approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The C2 represents a reliable prognostic marker in LA-NPC. The developed nomogram enables personalized risk evaluation and aids in clinical decisions regarding tailored therapeutic approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1909926","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:29:44Z","timestamp":1788150584000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic significance of immune-inflammatory and nutritional indicators in locoregionally advanced nasopharyngeal carcinoma"],"prefix":"10.3389","volume":"17","author":[{"given":"Sunqin","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Fujian Medical University","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University","place":["Quanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundong","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Emergency, The Second Affiliated Hospital of Fujian Medical University","place":["Quanzhou, 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