Analysis of the efficacy of camrelizumab/cetuximab neoadjuvant therapy in elderly patients with locally advanced laryngeal and hypopharyngeal cancer and the prognostic value of NLR/SII

Background Laryngeal and hypopharyngeal squamous cell carcinomas are among the most common head and neck malignancies, presenting a dual clinical challenge of achieving tumor eradication while preserving laryngeal function. This study evaluated the efficacy and preservation of laryngeal function effects of different neoadjuvant treatment regimens in middle-aged and elderly patients. Methods This retrospective study analyzed data from 110 middle-aged and elderly patients with locally advanced laryngeal and hypopharyngeal cancer. Patients were categorized into three groups based on the neoadjuvant treatment regimens administered: TP chemotherapy group (albumin-bound paclitaxel plus cisplatin), camrelizumab plus TP chemotherapy group, and cetuximab plus TP chemotherapy group. To make a Kaplan-Meier survival curve plot for 3 groups and do a log-rank test on these groups. We executed receiver operation capability (ROC) curve examination and a multivariate Coxproportional dangers regression to recognize separate prognostic determinants for 2-year overall survival (OS). Results Compared with TP chemotherapy alone, camrelizumab plus TP chemotherapy demonstrated significant improvements in multiple endpoints (all P < 0.05). The objective response rate (ORR) in the camrelizumab plus TP chemotherapy group was 90%, the 2-year progression-free survival (PFS) rate was 75.0%, and the 2-year laryngectomy-free survival (LFS) rate was 67.5%. However, the 2-year OS rate was 80.0%, indicating no significant improvement (P > 0.05). The cetuximab plus TP chemotherapy group did not demonstrate significant improvements in any of the above three endpoints (all P > 0.05). No significant difference was observed in the incidence of major adverse events among the three groups (P > 0.05). Cox regression analysis revealed that the systemic immunoinflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and N stage were independent prognostic factors. ROC curve analysis demonstrated that the areas under the curve (AUC) for SII and NLR in predicting prognosis were 0.839 (95% confidence interval [CI]: 0.755–0.923) and 0.853 (95% CI: 0.772–0.934), respectively. Conclusion In middle-aged and elderly patients with locally advanced laryngeal and hypopharyngeal carcinoma, combining camrelizumab with TP chemotherapy significantly enhanced short-term efficacy and improved laryngeal preservation rates while maintaining an acceptable safety profile. The inflammatory immune markers SII and NLR have valuable predictive utility in this patient population.