Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in intensity modulated radiation therapy for nasopharyngeal carcinoma

Abstract

BackgroundInflammatory response markers plays an important role in tumor progression. The aim of this analysis was to evaluate whether the neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) could predict the prognosis of nasopharyngeal carcinoma(NPC).Materials and Methods247 patients who underwent Intensity Modulated Radiation Therapy( IMRT )were enrolled from January 2012 and December 2012. NLR, and PLR were calculated from peripheral blood cell counts taken at pre-treatment. Optimal cutoff values of NLR and PLR were determined on the basis of receiver operating characteristic curve analysis. Overall survival (OS), progression-free survival(PFS), distant metastasis-free survival (DMFS) and loco-regional recurrence-free survival ( LRFS) rates were compared according to NLR and PLR level respectively. Multivariate analysis was performed to assess the prognostic value of NLR and PLR.ResultsThe 5-year estimated OS, PFS, LRFS and DFS were 87.2, 77.8, 96.9, and 86.2%, respectively. Our results shows that the NLR was significantly associated with T-stage (P < 0.05), N-stage (P < 0.05) and tumor stage(P < 0.05). PLR was significantly associated with T-stage (P < 0.05) and tumor stage(P < 0.05). NLR was an independent prognostic indicator for OS (HR: 3.259, P = 0.004), PFS (HR:7.093, P < 0.001), DMFS (HR: 6.576, P = 0.003), except for PLR. In subgroup analysis, adjuvant chemotherapy had no significantly improved survival for patients with high NLR.ConclusionsNLR is a strong prognostic factor for NPC patients. NLR might not be a useful indicator for selection of treatment strategies for loco-regionally advanced NPC.

A meta-analysis of the impact of neutrophil-to-lymphocyte ratio on treatment outcomes after radiotherapy for solid tumors

“…All articles were published after 2012 and analyzed OS as the primary endpoint. Analyses included PFS in 15 studies, [10,17–30] DFS in 11 studies, [16,17,31–37] DMFS in 8 studies, [19,23,27,30,38,39] DSS in 1 study, [23] and pathologic CR in 2 studies on preoperative CCRT. [25,40] The median NLR cut-off value was 3.1 (range 1.9–5.0).…”

Perioperative changes of inflammation-based biomarker for predicting the prognosis in colorectal cancer patients: a retrospective analysis

“…Inflammation is an essential component of the tumour microenvironment, and the changes in inflammatory cells might influence tumour progression, such as neoplastic cell proliferation, migration, invasion, collapse of anti-tumour immunity, metastasis, and so forth [5,6]. Accumulating evidence shows that the peripheral neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have been widely proposed as prognostic factors for many malignancies such as gastric cancer [7], nasopharyngeal carcinoma [8], liver cancer [9], and especially colorectal cancer [10]. Moreover, it is likely that the tumour microenvironment as well as systemic inflammatory response might be changed because of surgery [11].…”

Radiotherapy Effect on Complete Blood Count Parameter in Patients With Nasopharyngeal Carcinoma

“…It has been suggested that lymphocyte should also be considered as a prognostic marker that may reflect the immunological status of patients during and after treatment [13]. PLR and NLR pretreatment were also found to be a reliable predictor factor for overall survival, progression-free survival, diseasespecific survival, and distant metastasis-free survival [8,[14][15][16][17].…”