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Neutrophil–Lymphocyte Ratio and Absolute Lymphocyte Count as Prognostic Markers in Patients Treated with Curative-intent Radiotherapy for Non-small Cell Lung Cancer.
- Source :
-
Clinical Oncology . Aug2021, Vol. 33 Issue 8, pe331-e338. 8p. - Publication Year :
- 2021
-
Abstract
- The neutrophil–lymphocyte ratio (NLR) and the absolute lymphocyte count (ALC) have been proposed as prognostic markers in non-small cell lung cancer (NSCLC). The objective of this study was to examine the association of NLR/ALC before and after curative-intent radiotherapy for NSCLC on disease recurrence and overall survival. A retrospective study of consecutive patients who underwent curative-intent radiotherapy for NSCLC across nine sites in the UK from 1 October 2014 to 1 October 2016. A multivariate analysis was carried out to assess the ability of pre-treatment NLR/ALC, post-treatment NLR/ALC and change in NLR/ALC, adjusted for confounding factors using the Cox proportional hazards model, to predict disease recurrence and overall survival within 2 years of treatment. In total, 425 patients were identified with complete blood parameter values. None of the NLR/ALC parameters were independent predictors of disease recurrence. Higher pre-NLR, post-NLR and change in NLR plus lower post-ALC were all independent predictors of worse survival. Receiver operator curve analysis found a pre-NLR > 2.5 (odds ratio 1.71, 95% confidence interval 1.06–2.79, P < 0.05), a post-NLR > 5.5 (odds ratio 2.36, 95% confidence interval 1.49–3.76, P < 0.001), a change in NLR >3.6 (odds ratio 2.41, 95% confidence interval 1.5–3.91, P < 0.001) and a post-ALC < 0.8 (odds ratio 2.86, 95% confidence interval 1.76–4.69, P < 0.001) optimally predicted poor overall survival on both univariate and multivariate analysis when adjusted for confounding factors. Median overall survival for the high-versus low-risk groups were: pre-NLR 770 versus 1009 days (P = 0.34), post-NLR 596 versus 1287 days (P ≤ 0.001), change in NLR 553 versus 1214 days (P ≤ 0.001) and post-ALC 594 versus 1287 days (P ≤ 0.001). NLR and ALC, surrogate markers for systemic inflammation, have prognostic value in NSCLC patients treated with curative-intent radiotherapy. These simple and readily available parameters may have a future role in risk stratification post-treatment to inform the intensity of surveillance protocols. • Multi-centre UK study of 425 patients undergoing curative intent radiotherapy for NSCLC. • Higher pre-NLR, post-NLR and change in NLR plus lower post-ALC were all independent predictors of worse survival. • Pre-NLR > 2.5, post-NLR > 5.5, change in NLR > 3.6 and post-ALC < 0.8 optimally predicted poor survival. • Median OS high vs low-risk group: pre-NLR 770 vs 1009, post-NLR 596 vs 1287, change in NLR 553 vs 1214 and post-ALC 594 vs 1287 days. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09366555
- Volume :
- 33
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 151248270
- Full Text :
- https://doi.org/10.1016/j.clon.2021.03.019