Research Article Low Advanced Lung Cancer Inflammation Index Predicts Poor Prognosis in Locally Advanced Nasopharyngeal Carcinoma Patients Treated with Definitive Concurrent Chemoradiotherapy Erkan Topkan , 1 Yurday Ozdemir, 1 Ahmet Kucuk , 2 Ozan Cem Guler, 1 Ahmet Sezer, 3 Ali Ayberk Besen, 3 Huseyin Mertsoylu, 3 Sukran Senyurek, 4 Nulifer Kilic Durankus, 4 Yasemin Bolukbasi, 4 Ugur Selek, 4,5 and Berrin Pehlivan 6 1 Baskent University Medical Faculty, Department of Radiation Oncology, Adana, Turkey 2 Mersin City Hospital, Radiation Oncology Clinics, Mersin, Turkey 3 Baskent University Medical Faculty, Department of Medical Oncology, Adana, Turkey 4 Koc University, School of Medicine, Department of Radiation Oncology, Istanbul, Turkey 5 e University of Texas MD Anderson Cancer Center, Department of Radiation Oncology, Houston, TX, USA 6 Bahcesehir University, Department of Radiation Oncology, Istanbul, Turkey Correspondence should be addressed to Erkan Topkan; docdretopkan@gmail.com Received 2 May 2020; Revised 18 September 2020; Accepted 25 September 2020; Published 7 October 2020 Academic Editor: Ozkan Kanat Copyright © 2020 Erkan Topkan et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. We aimed to retrospectively investigate the prognostic worth of pretreatment advanced lung cancer inflammation index (ALI) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients treated with concurrent chemoradiotherapy (C-CRT). Patients and Methods. A total of 164 LA-NPC patients treated with cisplatinum-based definitive C-CRT were included in this retrospective cohort analysis. e convenience of ideal pre-C-CRT ALI cut-offs affecting survival results was searched by employing the receiver operating characteristic (ROC) curve analyses. e primary endpoint was the link between the ALI groups and overall survival (OS), while cancer-specific survival (CSS), locoregional progression-free survival [LR(PFS)], distant metastasis-free survival (DMFS), and PFS comprised the secondary endpoints. Results. e ROC curve analyses distinguished a rounded ALI cut-off score of 24.2 that arranged the patients into two cohorts [ALI ≥ 24.2 (N � 94) versus < 24.2 (N � 70)] with significantly distinct CSS, OS, DMFS, and PFS outcomes, except for the LRPFS. At a median follow-up time of 79.2 months (range: 6–141), the comparative analyses showed that ALI < 24.2 cohort had significantly shorter median CSS, OS, DMFS, and PFS time than the ALI ≥ 24.2 cohort (P < 0.001for each), which retained significance at 5- (P < 0.001) and 10-year (P < 0.001) time points. In multivariate analyses, ALI < 24.2 was asserted to be an independent predictor of the worse prognosis for each endpoint (P < 0.001for each) in addition to the tumor stage (T-stage) (P < 0.05 for all endpoints) and nodal stage (N-stage) (P < 0.05 for all endpoints). Conclusion. As a novel prognostic index, the pretreatment ALI < 24.2 appeared to be strongly associated with significantly diminished survival outcomes in LA-NPC patients treated with C-CRT independent of the universally recognized T- and N-stages. 1. Introduction At present, the TNM (tumor-node-metastasis) staging system represents the foremost trustworthy framework for the prognostication of the locally advanced nasopharyngeal carcinoma (LA-NPC) patients undergoing oncologic inter- ventions. However, unfortunately, the comprehensive TNM framework neglects the substantial tumor- and host-related biological differences by relying exclusively upon the locoregional tumor expansions of the primary tumor [1, 2]. ese biological differences may instigate divergent clinical outcomes among patients with indistinguishable LA-NPC stages even after the equivalent anticancer interventions, which robustly stresses the specific call for the discovery of novel and more powerful biomarkers for better prognostic categorization of such patients. Hindawi Journal of Oncology Volume 2020, Article ID 3127275, 10 pages https://doi.org/10.1155/2020/3127275